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PubMed1991

Effect of a tricyclic antidepressant and opiate antagonist on binge-eating behavior in normoweight bulimic and obese, binge-eating subjects.

A subset of the obese population (25-30%) has been reported to engage in binge eating at least twice weekly (bingers) and to exhibit personality traits and food attitudes similar to those of normoweight bulimic women (bulimics). Tricyclic antidepressants and opiate antagonists effectively suppress binge eating in normoweight bulimics. This 8-wk placebo-controlled, double-blind trial investigated the effect of naltrexone and imipramine on 33 obese bingers and 22 bulimics. Naltrexone (100-150 mg/d) produced a significant reduction in binge duration in bulimics (36 +/- 16%, median +/- SIQR; P = 0.02) whereas imipramine significantly reduced binge duration in obese bingers (88 +/- 31%; P = 0.02). A strong placebo effect was observed in obese bingers and, although a reduction in binge frequency occurred with both naltrexone and imipramine, it was not significantly different from the effect in placebo control subjects. We conclude that naltrexone and imipramine may be useful agents in the treatment of binge eating.

Adult↗

PubMed2004

The Eat Well SA project: an evaluation-based case study in building capacity for promoting healthy eating.

The term 'capacity building' is used in the health promotion literature to mean investing in communities, organizations and structures to enhance access to knowledge, skills and resources needed to conduct effective health programs. The Eat Well SA project aimed to increase consumption of healthy food by children, young people and their families in South Australia. The project evaluation demonstrated that awareness about healthy eating among stakeholders across a range of sectors, coalitions and partnerships to promote healthy eating and sustainable programs had been developed. The project achievements were analysed further using a capacity-building framework. This analysis showed that partnership development was a key strategy for success, leading to increased problem-solving capacity among key stakeholders and workers from education, child care, health, transport and food industry sectors. It was also a strategy that required concerted effort and review. New and ongoing programs were initiated and institutionalized within other sectors, notably the child care, vocational education and transport sectors. A model for planning and evaluating nutrition health promotion work is described.

Adolescent↗

PubMed2006

Why do women with alcohol problems binge eat? Exploring connections between binge eating and heavy drinking in women receiving treatment for alcohol problems.

Questionnaires assessing heavy drinking and binge eating were administered to 58 women with alcohol problems. A sub-sample of the binge-eaters then participated in qualitative interviews about their perceptions of the connections between their two problems. Seventy-one percent self-identified as binge-eaters with most reporting 'severe' binge eating. Binge-eaters were younger, more frequent drinkers and drank more often for emotional relief than non-binge-eaters. Binge eating and heavy drinking appeared to serve similar functions in a given client (i.e. emotional relief or reward functions). We discuss implications of the findings for the development of better treatments for women struggling with both health issues.

Adult↗

PubMed2003

[Eating disorders: anorexia nervosa, bulimia, binge eating].

We present an overview of three different eating disorders which seem to have an increasing prevalence, especially among young women between 12 and 20 years of age. Anorexia and bulimia nervosa are "threshold disorders" which usually become manifest for the first time during the transition from childhood to early adult life. Eating disorders are chronic disorders and often take a course of 6 or more years. Remission, improvements and symptom change can be expected even after many years of the disorder. Psychiatric comorbidity which occurs in more than 50% of eating disordered patients is of prime importance for prognosis. Depression, anxiety disorders, obsessive-compulsive disorders, and personality disorders are most common. There is a variety of complex in- and outpatient treatments with different components which have to be chosen according to the individual case.

Adolescent↗

PubMed1997

Difficulties in trying to eat healthier: descriptive analysis of perceived barriers for healthy eating.

OBJECTIVE: To determine the factors which are perceived to be important barriers to healthy eating among European adults. DESIGN: A cross sectional study in which quota-controlled, nationally-representative samples of approximately 1000 adults from each country completed a face-to-face interview-assisted questionnaire. SETTING: The survey was conducted between October 1995 and February 1996 in the 15 member states of the European Union. SUBJECTS: 14,331 subjects (aged 15 y upwards) completed the questionnaire. Data were weighted by population size for each country and by sex, age and regional distribution within each member state. RESULTS: The study demonstrates a great variability in the perceived barriers to healthy eating between different EU countries. Lack of time was the most frequently mentioned difficulty among EU subjects for not following nutritional advice (24% of total EU sample). This barrier was frequently reported by the younger and the higher education people. Other frequently reported barriers were giving up favourite foods (23%) and willpower (18%). Thus healthy diets do not appear to be viewed as an easy or attractive alternative to current diets. There was wide geographical variation in the number of subjects mentioning price as an important barrier to healthy eating (15% in overall EU sample) ranging from less than 10% in Germany and Italy to 23% in the UK and 24% in Luxembourg.

Adolescent↗

PubMed2003

Psychometric properties of Eating Disorder Inventory for Children (EDI-C) in Swedish girls with and without a known eating disorder.

OBJECTIVE: To evaluate the Swedish version of the Eating Disorder Inventory (EDI-C) for the internal consistency, factor structure and ability to discriminate between adolescent girls with and without a known eating disorder (ED). METHODS: Completely answered EDI-C questionnaires were available from 201 girls diagnosed with an ED and from 2073 schoolgirls. The girls were adolescents attending grade 7-12. RESULTS: Internal consistency was 0.70-0.91 for the ED group. Eleven factors with eigenvalue > 2.2 explained 56% of the variance and showed satisfying correspondence to the proposed constructs of EDI-C. A discriminant analysis classified 85.6% of the cases correctly. The three most important discriminating subscales were Drive for Thinness, Asceticism and Body Dissatisfaction. All subscales except Maturity Fears showed significantly higher mean values for the ED group. CONCLUSIONS: The results indicate that the psychometric properties of EDI-C are comparable to the properties of EDI-2. EDI-C should be preferred for adolescents since its statements suit this age group.

Adolescent↗

PubMed2006

Eating for pleasure or just wanting to eat? Reconsidering sensory hedonic responses as a driver of obesity.

Pleasure from foods can stimulate "non-homoeostatic" eating, and might therefore also potentially contribute toward obesity. However, obesity is not reliably associated with heightened hedonic responses to foods. This apparent discrepancy may reflect the differentiation between "liking" and "wanting". Supporting this, behavioural and neurophysiological data on responsiveness to food-related cues indicate that obesity may be associated with increased motivation for food consumption, without necessarily any greater explicit pleasure derived from the orosensory experience of eating. This distinction may have important implications for further research, and applications in commercial and public health approaches to modifying energy intakes.

Eating↗

PubMed2003

Night eating syndrome: effects of brief relaxation training on stress, mood, hunger, and eating patterns.

BACKGROUND: Night eating syndrome (NES) is characterized by a lack of appetite in the morning, consumption of 50% or more of daily food intake after 6:00 p.m., and difficulty falling and/or staying asleep. It has been associated with stress and with poor results at attempts to lose weight. OBJECTIVE: The purpose of this study was to determine whether a relaxation intervention (Abbreviated Progressive Muscle Relaxation Therapy, APRT) that has been shown to significantly reduce stress levels in normal, healthy adults would also benefit an NES sample. RESEARCH METHODS AND PROCEDURES: A total of 20 adults with NES were randomly assigned to either a relaxation training (APRT) or a Control (quietly sitting for the same amount of time) group, and all subjects attended two laboratory sessions 1 week apart. Pre- and postsession indices of stress, anxiety, relaxation, and salivary cortisol were obtained, as well as Day 1 and Day 8 indices of mood. Food diaries and hunger ratings were also obtained. RESULTS: The results indicated that 20 min of a muscle relaxation exercise significantly reduced stress, anxiety, and salivary cortisol immediately postsession. After practicing these exercises daily for a week, subjects exhibited lowered stress, anxiety, fatigue, anger, and depression on Day 8. APRT was also associated with significantly higher a.m. and lower p.m. ratings of hunger, and a trend of both more breakfast and less night-time eating. DISCUSSION: These data support the role of stress and anxiety in NES and suggest that practicing relaxation may be an important component of treatment for this condition.

Adult↗

PubMed2003

Why do kids eat healthful food? Perceived benefits of and barriers to healthful eating and physical activity among children and adolescents.

The goal was to have children and adolescents identify and rank the major perceived benefits of and barriers to healthful eating and physical activity and to suggest strategies for overcoming barriers. Semistructured, in-depth focus groups were undertaken using standardized questions and prompts. Students in grades 2 through 11(ages 7 through 17; N=213) from 34 randomly selected schools participated in 38 focus groups. Major benefits of healthful eating included improvements to cognitive and physical performance, fitness, endurance, psychological benefits, physical sensation (feeling good physically), and production of energy. Barriers included convenience, taste, and social factors. Benefits of physical activity included social benefits, enhancement of psychological status, physical sensation, and sports performance. Barriers included a preference for indoor activities, lack of energy and motivation, time constraints, and social factors. Suggested strategies for overcoming barriers included support from parents and school staff, better planning, time management, self-motivation, education, restructuring the physical environment, and greater variety of physical activities.

Adolescent↗

PubMed2002

[Changes of body image and body awareness in eating-disorder and non eating-disorder patients after inpatient-therapy].

Altered body image and body awareness have significant clinical implications not only for patients with eating disorders. We evaluated therapy-outcome including distortions in body image in 61 inpatients using two instruments assessing body image (FKB-20 Clement and Löwe, and FBeK Strauss and Richter-Appelt ). Eating disorder subjects, as expected, showed the most severely disturbed body image with negative attitudes towards their own body and restricted body dynamics. While body image improved over all diagnostic groups after treatment, anorectic patients improved less than others. This finding confirms the clinical observation of the limited therapeutic influence on body image distortions in anorectic patients. Our results show, that the body image questionnaire FKB-20 discriminates well between healthy and psychosomatically diseased patients and is a suitable instrument for process- and outcome-evaluation.

Adolescent↗

PubMed1999

Weight control in wrestling: eating disorders or disordered eating?

PURPOSE: Several recent studies have pointed out that the weight loss techniques used by wrestlers to make weight are similar to the behavior of bulimics. The purpose of this study was to determine whether an increased risk of bulimia nervosa existed for a group of junior high and high school wrestlers. METHODS: Wrestlers (N = 85) completed the Eating Disorder Inventory (EDI) once during the season, and once during the off-season. A comparison group of nonwrestlers (N = 75) also completed the questionnaire. RESULTS: No significant differences were found between the number of in-season wrestlers and nonwrestlers classified as "at risk" for bulimia nervosa. Significant differences were revealed, however, between in-season wrestlers and nonwrestlers, and between in-season wrestlers and off-season wrestlers, on the Drive for Thinness subscale. In both cases, significantly more in-season wrestlers scored above the "at risk" cutoff on the subscale. CONCLUSIONS: These results indicate that although in-season wrestlers are more weight conscious than nonwrestlers, these feelings and attitudes are transient. All subjects classified as "at risk" also participated in an interview which followed the format of the Eating Disorder Examination. Interviews with in-season wrestlers revealed that their concerns with weight were due entirely to the demands of wrestling, and did not meet the severity level required for a diagnosis of bulimia nervosa.

Adolescent↗

PubMed2002

Eat less, walk more. Enjoyable eating for type 2 diabetes.

BACKGROUND: Lifestyle management is the basis of diabetes treatment. In most cases, healthy eating, activity and weight loss can result in significant improvements in blood glucose, lipids and overall health. General practitioners have a key role in encouraging and supporting patients with diabetes to make lifestyle changes. OBJECTIVE: This article outlines the general lifestyle nutritional recommendations of type 2 diabetes and provides practical ideas for GPs to help patients achieve lifestyle goals. DISCUSSION: Although lifestyle is the cornerstone of diabetes management, it is the most difficult part of management to implement. Adherence to recommended eating and activity schedules is low. A complete dietary assessment requires input from a dietitian and support from the GP.

Alcohol Drinking↗

PubMed2001

Hepatic gluconeogenesis in rats trained to eat a single meal daily. Role of eating periodicity and the amount of food ingested in the last meal.

Rats trained to eat a single daily meal (MF rats), from 8:00-10:00 a.m., increased food intake from the 1st to the 12th (125%) day of feeding training. In this work we compared the influence of the higher food ingestion in the last meal and feeding training on hepatic gluconeogenesis. Thus, rats at the 1st (MF(1st day-5g) group) and 13th day (MF(13th day-5g) group) of training, refed with a fixed amount of food (5g) were employed. In addition, a third group of MF rats, refed on day 12 with 75% (12g) of the food ingested by MF rats on the 13th day of the feeding training (MF(13th day-12g)) was included. The experiments were performed at 22 h after meal (8:00 a.m.). Our results demonstrated that feeding training had a crucial role in determining gluconeogenesis from pyruvate (5 mM). Additionally, gluconeogenesis from L-glutamine (5 mM) was influenced by periodicity of eating and the amount of food ingested in the last meal. In contrast, gluconeogenesis from L-alanine (5 mM) was not influenced by both factors. In conclusion, our findings suggested that the hepatic gluconeogenesis was influenced by food ingestion and/or feeding training depending of the substrate investigated. These effects on gluconeogenesis may have implications for use in diabetic regimens.

Adaptation, Physiological↗

PubMed2000

Binge eating disorder and bulimia nervosa: differences in the quality and quantity of binge eating episodes.

OBJECTIVE: This study sought to examine the differences in the quantity and quality of binges between binge eating disorder (BED) and bulimia nervosa. METHOD: Patients (N = 77) seeking treatment for eating disorders were assessed on binge content. RESULTS: Results suggest no differences in binge quantity with BED and bulimia, but there were differences in the binge quality. The binges of bulimics were higher in carbohydrates and sugar than those with BED. DISCUSSION: The higher levels of obesity of our BED individuals may account for the lack of differences between those with bulimia and BED. The importance of increasing our knowledge of the continuum of weight and binging is discussed.

Adult↗

PubMed1994

Binge eating disorder and the proposed DSM-IV criteria: psychometric analysis of the Questionnaire of Eating and Weight Patterns.

Proposed binge eating disorder (BED) diagnostic criteria were investigated to provide necessary psychometric characteristics and explore their utility in assessment. One hundred four subjects (52 self-referred bingers, 52 comparison subjects) completed an initial administration of the Questionnaire of Eating and Weight Patterns (QEWP). The results supported the ability of the two core BED criteria (i.e., episodic overeating, loss of control) to discriminate between clinical and nonclinical binge eaters. Thirty-nine of the self-referred and 40 of the comparison subjects completed a second QEWP administration 3 weeks later. Results indicated that the BED diagnosis was moderately stable over the 3-week interval (kappa = .58, combined sample). Using self-monitoring data completed by the self-referred subjects, predictive efficiency analyses indicated that the QEWP was able to identify both high and low probability binge eaters. Implications of the findings for the definition, assessment, and utility of the BED diagnosis are discussed.

Adult↗

PubMed1999

Restrained eating among vegetarians: does a vegetarian eating style mask concerns about weight?

The present study explored the relationships among dietary style (ranging from meat eating to veganism), cognitive restraint and feminist values. Two-hundred and twenty-seven participants with varying dietary styles completed the restraint subscale of the Three Factor Eating Questionnaire (TFEQ) and Attitudes Towards Feminism Scale (ATFS). Results indicated that among males, those who are high in cognitive restraint are more likely to exhibit a vegetarian dietary style than those low in cognitive restraint. Among women who are high in feminist values, those with high cognitive restraint are more likely to exhibit a vegetarian dietary style than those with low cognitive restraint, whereas for women low in feminist values those with high and low cognitive restraint are equally likely to exhibit vegetarian and non-vegetarian dietary styles. It is suggested that for some individuals, adoption of a vegetarian dietary style is an attempt to mask their dieting behaviour from others.

Adolescent↗

PubMed2005

The assessment of binge eating disorder in obese women: a comparison of the binge eating scale with the structured clinical interview for the DSM-IV.

The purpose of the present study was to evaluate the clinical usefulness of the Portuguese version of the Binge Eating Scale (BES) to assess binge eating disorder (BED) in a clinical sample. The BES is a self-reported instrument developed to identify binge eaters within the obese population. The scale, at the cutoff point of 17, was compared with the Structured Clinical Interview for the DSM-IV-Patient version (SCID-I/P). It was administered to 178 obese Brazilian women, aged 18 to 60 years, seeking treatment for obesity at an outpatient clinic. To assess the test-retest reliability, 121 individuals filled the instrument again 15 days later. The Portuguese version of BES showed a sensitivity of 97.8%, a specificity of 47.7%, a positive predictive value of 66.7% and a negative predictive value of 95.3%. The test-retest reliability, measured by kappa statistics, was 0.66. Cronbach's alpha was 0.89. These results suggest that the BES is valid as a screening instrument for BED in obese Brazilian women seeking treatment for obesity.

Adolescent↗

PubMed2004

Adolescents eating diets rich in either lean beef or lean poultry and fish reduced fat and saturated fat intake and those eating beef maintained serum ferritin status.

Reducing red meat intake to lower serum cholesterol may also lower iron and zinc intake. Eighty-six seventh and eighth graders who enrolled in a study comparing serum ferritin, zinc, and cholesterol levels were randomized to a low-fat eating pattern emphasizing either lean beef or lean poultry and fish. Serum data and three 24-hour recalls were collected at baseline and 3 months. The lean beef group ate significantly more beef [26 (4, 37) g/d; P<.01] and both groups reduced total and saturated fat intake. Although serum ferritin level change between baseline and intervention was significantly different between the lean beef and lean poultry and fish groups (median [interquartile range] 0.7 [-6, 8] and -6.8 [-12, 2] microg/dL, respectively), the drop in the lean poultry and fish group was not clinically significant. No differences were observed in iron and zinc intake or in serum zinc and cholesterol levels. Teenagers eating diets low in saturated fat may benefit from adequate amounts of lean red meat.

Adolescent↗