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PubMed1992

Differences in energy metabolism between normal weight 'large-eating' and 'small-eating' women.

Nine 'large-eating' (approximately 12 MJ/d) and nine 'small-eating' (approximately 5.3 MJ/d) women were selected from the population on the basis of diet and activity diaries. At rest and in the post-absorptive state the rate of oxygen consumption (VO2)/kg fat-free mass (FFM) and rate of carbon dioxide production (VCO2)/kg FFM were 9-17% higher (P < 0.05) in the 'large-eaters' than in the 'small-eaters'. As energy expenditure was increased by walking at 2.4, 3.9 and 5.4 km/h the differences between the two experimental groups for both VO2/kg FFM and VCO2/kg FFM were decreased to negligible values, but energy expended on a body-weight basis (MJ/kg per min) remained significantly higher (5-10%) in 'large-eaters'. Oral temperature was also consistently higher (up to 0.5 degrees) in this group both at rest and during sitting, standing and walking activities. Although the average thermic effect of a standardized liquid meal tended to be higher (27%; not significant) in the 'small-eaters', the other results demonstrate that the 'large-eating' females had a markedly higher rate of energy expenditure at rest and during light physical activities.

Adult↗

PubMed1992

Selective processing of eating, weight and shape related words in patients with eating disorders and dieters.

The Stroop colour-naming task was used to investigate selective processing of eating, weight and shape related words in two groups of dieters, patients with anorexia nervosa, patients with bulimia nervosa and a group of non-dieting controls. 'Normal dieters' were not different from the non-dieting controls. Dieters with a history of features of an eating disorder but no diagnosis and the patients with anorexia nervosa, like the patients with bulimia nervosa, showed selective processing of information related to eating, weight and shape.

Anorexia Nervosa↗

PubMed1995

Combined cognitive-behavioral, psychopharmacological and nutritional therapy in eating disorders. 2. Anorexia nervosa--binge-eating/purging type.

Thirteen women with anorexia nervosa, binge-eating/purging type (AN-BP), 17-43 years old, were treated with a 4-month course of combined cognitive-behavioral, nutritional and antidepressant therapy (7 with amineptine and 6 with fluoxetine). Patients were monitored before and after 1, 2 and 4 months of treatment for body mass index (BMI), for eating disorder symptoms by the Eating Disorder Inventory (EDI) and the Bulimic Investigation Test (BITE) and for depression and anxiety by the Hamilton Rating Scales for Depression and for Anxiety. BMI, EDI scores, depression and anxiety improved significantly and equally in the two groups during the 4 months of therapy, while BITE scores did not change.

Adolescent↗

PubMedDate not supplied

Diagnostic issues in eating disorders: two cases of atypical eating disorder.

Two cases with significant eating disturbances are described. Both possess several characteristic symptoms of anorexia but lack a primary drive for thinness or body image disturbances. Similarly, neither engaged in recurrent episodes of binge eating which is typical of bulimia. The authors propose the differential diagnoses of atypical eating disorder rather than conversion disorder as a more descriptive and accurate diagnostic label.

Adolescent↗

PubMed1992

[A project on eating disorders. Increasing of competence within mental health services in treating severe eating disorders].

We describe a two-year education programme for health workers treating patients with eating disorders. The intention of the programme was partly to increase the knowledge and ability of the participants themselves, and partly to spread this knowledge to other health workers not directly involved in the programme. The programme attracted 66 participants. It was composed of theoretical lectures, group supervision, clinical work with patients with eating disorders and individual supervision as needed. Evaluation at the end of the programme showed a greater feeling of competence and more positive attitudes towards treating these particular patients. More than 80% of the participants had supervised other health workers outside the programme, and nearly 50% had held lectures on the treatment of eating disorders.

Clinical Competence↗

PubMed1993

Eating behavior in binge eating disorder.

In order to examine the eating behavior of individuals with the newly proposed diagnosis, binge eating disorder (BED), standardized meals were served to 20 obese women, 10 with BED and 10 without BED. When asked to binge eat from a multiple-item array of foods, obese subjects with BED consumed significantly more calories than did obese subjects without BED. Significant differences between the two groups were also found on several of the self-report measures.

Adult↗

PubMed2000

Effects of acute food deprivation on eating behavior in eating disorders.

OBJECTIVE: Effects of acute food deprivation on eating behavior in bulimic patients and controls were investigated. It was predicted that food deprivation would increase overall food intake and result in overeating in bulimics. METHOD: Following 19 hr of food deprivation (in which breakfast and lunch were skipped), or no deprivation, food intake was measured in 9 inpatients with anorexia nervosa (binge eating/purging subtype, ANB), 10 inpatient (BN/in) and 9 outpatient (BN/out) normal-weight bulimics, and 11 unrestrained and 10 restrained controls. RESULTS: A general trend for increased food intake following deprivation was found. However, only BN/in patients consumed significantly more and selected higher energy foods following deprivation. ANB patients demonstrated the greatest degree of variability in intake and the least magnitude of change in ratings as a function of eating. DISCUSSION: A period of acute food deprivation did not trigger marked eating pathology as evidenced by overconsumption. Chronic dietary restraint may be a more potent precipitating factor in overeating than absolute number of hours of food restriction.

Adult↗

PubMed2003

Circulating levels of neuroactive steroids in patients with binge eating disorder: a comparison with nonobese healthy controls and non-binge eating obese subjects.

OBJECTIVES: Increased plasma levels of allopregnenolone (3alpha,5alpha-tetrahydroprogesterone [3alpha,5alpha-THP]), dehydroepiandrosterone (DHEA), and DHEA sulphate (DHEA-S) have been reported in patients with anorexia nervosa or bulimia nervosa. To assess whether those changes are related to malnutrition, we investigated plasma levels of neuroactive steroids in women with binge eating disorder (BED) who compulsively binge as bulimic patients, but do not incur malnutrition. METHODS: Sixty-eight women participated in the study (31 nonobese healthy controls, 9 nonobese patients with BED, 16 obese patients with BED, and 12 obese non-binge eating women). Blood samples were collected in the morning for determination of plasma levels of 3alpha,5alpha-THP, DHEA, DHEA-S, and cortisol. RESULTS: Nonobese BED women had significantly higher plasma levels of DHEA, DHEA-S, and 3alpha,5alpha-THP than nonobese healthy women. Similarly, obese individuals with BED exhibited significantly higher neurosteroid plasma levels than non-binge eating obese subjects. No significant differences in plasma cortisol levels were observed among the groups. DISCUSSION: This study shows increased plasma levels of neuroactive steroids in BED patients. These findings could have been influenced by methodologic limitations (e.g., the absence of diurnal sampling). However, they suggest that if malnutrition is involved in the determination of increased plasma levels of neuroactive steroids in people with anorexia or bulimia nervosa, then different factors may induce similar effects in people with BED. Alternatively, common unknown factors could be responsible for neurosteroid changes in anorexia nervosa, bulimia nervosa, and BED.

Adult↗

PubMed2004

Eating disorders symptomatology and inpatient treatment experience in eating-disordered subjects.

OBJECTIVE: This study aimed to examine whether eating disorder (ED) subjects with and without a history of inpatient treatment differ in the severity of symptoms as measured by the Eating Disorders Inventory (EDI-1). METHOD: In a sample of 222 women (66 women with anorexia nervosa, 126 women with bulimia nervosa, and 30 women with eating disorders not otherwise specified), the history of inpatient treatment was assessed and the EDI was administered. RESULTS: Fifty percent of the participants had received previous inpatient treatment. The group with past inpatient treatment had significantly higher scores on the EDI subscales Body Dissatisfaction, Ineffectiveness, and Interpersonal Distrust than the group without inpatient treatment experience. DISCUSSION: ED subjects with and without inpatient treatment showed different profiles on the EDI subscales. The fact that these two groups differ in specific ED symptoms may represent a bias in ED studies when samples with heterogeneous treatment contact history are recruited.

Adolescent↗

PubMed2001

Binge eating disorder and night eating syndrome: psychological and behavioral characteristics.

OBJECTIVE: The present study was designed to examine the psychological and behavioral characteristics associated with both night eating syndrome (NES) and binge eating disorder (BED) in 42 males and 41 females who were enrolled in a university-based weight loss center. METHOD: Individuals were classified into one of four groups: NES only (N = 23), BED only (N = 13), both NES and BED (N = 13), or no diagnoses of an eating disorder (N = 34). Analyses of covariance (covarying for age and gender) were conducted to compare patients with BED and NES. RESULTS: NES patients scored lower on disinhibition than BED patients (p <.01). Also, individuals who met criteria for both disorders scored higher than NES only patients on state anxiety (p <.01), disinhibition (p =.08), and trait anxiety (p =.08). DISCUSSION: These results suggest that NES represents a subcategory among the obese, which also overlaps with binge eaters. In addition, anxiety distinguished individuals who met criteria for both disorders from patients who were diagnosed with either NES or BED.

Adolescent↗

PubMed2007

Evaluating binge eating disorder in children: development of the children's binge eating disorder scale (C-BEDS).

OBJECTIVE: Binge eating disorder (BED) may manifest itself differently in children than adults. Recently researchers have proposed provisional criteria for measuring BED in children. The purpose of this study was to develop a brief, simple, structured, interviewer-administered scale (C-BEDS) to measure BED in children according to the provisional criteria and to compare diagnostic results with SCID diagnoses. METHOD: A total of 55 children between the ages of 5 and 13 were interviewed with both the SCID and the C-BEDS. RESULTS: There was a significant association between the two measures (p = .001). Both measures adequately identified children with binge eating behaviors. CONCLUSION: Both the provisional criteria and the C-BEDS may be developmentally appropriate for use with children, although the C-BEDS may be a better screening instrument as it quickly identified children with subsyndromal BED. If used by physicians and other health providers, this brief measure may assist with identifying early onset binge eating behaviors and avoiding the associated consequences, including adult BED, obesity, and other comorbidities.

Adolescent↗

PubMed2004

Eating disorder emergencies: understanding the medical complexities of the hospitalized eating disordered patient.

Eating disorders are maladaptive eating behaviors that typically develop in adolescence and early adulthood. Psychiatric maladies and comorbid conditions, especially insulin-dependent diabetes mellitus, frequently co-exist with eating disorders. Serious medical complications affecting all organs and tissues can develop and result in numerous emergent hospitalizations. This article reviews the pathophysiologies of anorexia nervosa, bulimia nervosa, and orthorexia nervosa and discusses the complexities associated with the treatment of medical complications seen in these patients.

Adolescent↗

PubMed2006

How do children with eating disorders differ from adolescents with eating disorders at initial evaluation?

PURPOSE: To compare the clinical presentation of children with eating disorders (ED) to that of adolescents with ED. METHODS: Demographic, medical, and psychiatric data of all 959 in- and outpatients (85 males, 874 females) 8-19 years of age diagnosed with ED that presented to an academic center between 1997 and 2005 were examined via retrospective record review. Young patients (n = 109) were defined as aged < 13 years at presentation, and older patients (n = 850) > or = 13 years and < 20 years. RESULTS: Compared with older adolescents (mean 15.6 years, SD 1.4), younger patients (mean 11.6 years, SD 1.2) were more likely to be male (chi2 = 9.25, p < .005) or diagnosed with eating disorder not otherwise specified (EDNOS) (chi2 = 5.09, p < or = .05), and less likely to be diagnosed with bulimia nervosa (BN) (chi2 = 13.45, p < or = .001). There were no significant differences in anorexia nervosa (AN) diagnoses between groups. Young patients were less likely to report purging (chi2 = 26.21, p < .001), binge eating (chi2 = 26.53, p < .001), diet pill (chi2 = 13.31, p < .001) or laxative use (chi2 = 6.82, p < .001) when compared with older teens. Young patients weighed less in percentage ideal body weight (p < .05), had a shorter duration of disease (p < .001), and had lost weight more rapidly than older adolescent patients (p < or = .001). CONCLUSIONS: There are important diagnostic and gender differences in younger patients. Young ED patients presented at a lower percentage of ideal body weight and had lost weight more rapidly, which may put them at higher risk for future growth sequelae than their older counterparts.

Adolescent↗

PubMed2006

Non-eating disorders psychopathology in children and adolescents with eating disorders: implications for malnutrition and symptom severity.

OBJECTIVES: To compare the general psychopathology in an eating disorders (ED) and a child mental health outpatient sample and investigate the implications of comorbidity on psychological and physical measures of ED severity. METHODS: One hundred thirty-six children and adolescents with a DSM-IV ED diagnosis were compared with age- and gender-matched controls. Measures included the Eating Disorders Examination and the Child Behavior Checklist. RESULTS: The ED group had lower general and externalizing psychopathology scores and no difference in internalizing (anxiety-depression) symptoms. Of the anorexia nervosa group, 49% experienced comorbid psychopathology. This group had significantly higher ED psychopathology, longer duration of illness, and more gastrointestinal symptoms, but no difference in malnutrition status. Eating disorders not otherwise specified (EDNos) group measures were less influenced by comorbidity status. CONCLUSIONS: Anxiety-depressive symptoms are very common in children and adolescents with EDs. Comorbidity status influences illness severity, especially in the anorexia nervosa group. The management implications of these findings are discussed.

Adolescent↗

PubMedDate not supplied

Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features.

OBJECTIVE: To assess the prevalence of night eating syndrome (NES) and binge eating disorder (BED) and their related behavioral and psychological correlates in persons who sought bariatric surgery. RESEARCH METHODS AND PROCEDURES: A consecutive series of 215 persons with extreme obesity (82% women, 70% European American) completed the Weight and Lifestyle Inventory and a semistructured interview as part of a pre-surgery behavioral/psychological assessment. Diagnoses for NES and BED were based on graded diagnostic criteria. RESULTS: Percentages of participants who met diagnostic criteria for NES by interview were 1.9% for the strictest definition and 8.9% across all definitions of NES. After interview, full DSM-TR criteria for BED were met by 4.2%; an additional 1.4% reported binge eating at least once per week. Self-reported prevalence of NES and BED were higher. Those with NES or BED had significantly more symptoms of depression and a greater history of psychological complications than the remaining sample. DISCUSSION: The prevalence rates of NES and BED among this population of bariatric surgery candidates were lower than expected based on previous reports. Findings and hypotheses regarding lowered prevalence rates are discussed.

Adult↗

PubMed2004

Night-time eating in men and women with binge eating disorder.

This study examined the frequency of night-time eating (NE) and its correlates in men and women with binge eating disorder (BED). Two-hundred and seven consecutively evaluated adults (45 men and 162 women) with BED were assessed with semi-structured interviews and a battery of behavioral and psychological measures. Overall, 28% (N = 58) of the participants reported NE. A significantly higher proportion of men (42%) than women (24%) reported NE. Overall, participants who reported NE had a significantly higher body mass index, but otherwise differed little from those who did not report NE. Men and women without NE differed little on behavioral and psychological measures, whereas women with NE had significantly higher levels of eating-, weight-, and shape-concerns than men with NE.

Adult↗

PubMed2006

Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features.

Adult↗

PubMed2005

Why do adolescents eat what they eat? Personal and social environmental predictors of fruit, snack and breakfast consumption among 12-14-year-old Dutch students.

OBJECTIVE: The aim of the study was to investigate the relative importance of personal and social environmental predictors of the consumption of fruit, high-fat snacks and breakfast. DESIGN: A school-based cross-sectional survey. Data were collected through written questionnaires. SETTING: Students from eight schools in the southern part of The Netherlands. SUBJECTS: Six hundred and one students from preparatory secondary vocational education schools. RESULTS: About a quarter of the variation in actual behaviours and intentions to change the behaviours could be explained. Stepwise multiple regression analysis revealed that, for all three behaviours, higher intention to change was especially associated with a more positive attitude and subjective norm, and higher intentions to increase fruit intake with more positive self-efficacy expectations. With regard to actual consumption, a more positive attitude towards eating fruit was the only significant correlate of a higher consumption of fruit. A more positive attitude towards eating high-fat snacks, perceived lower intake of the mother, and higher food availability and accessibility were associated with consumption of high-fat snacks, and a more positive attitude to breakfast more frequently was associated with more frequent breakfast consumption. CONCLUSION: The results indicate that adolescents' attitudes are the most important determinants of different health-related eating behaviours and intentions to change. Interventions promoting a healthy diet for adolescents should include creative strategies to achieve positive associations with healthy dietary changes.

Adolescent↗