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Seven eating styles linked to overeating, overweight, and obesity.

OBJECTIVE: To broaden the perspective on the causes of overeating, overweight, and obesity and provide cross-cultural, comprehensive treatment approaches. BACKGROUND: Through food-related research into the world's wisdom traditions, cultural traditions, Eastern healing systems, and Western nutritional science, the authors present recurrent themes derived from ways in which cultures regarded, experienced, prepared, and shared food for millennia. DESIGN: An 80-item questionnaire, designed to measure food, nutrition, and eating themes was administered to 5,256 participants who registered for a Web-based integrative nutrition e-course. When the 80-items were factor analyzed separately in two randomly split halves of the sample as well as within age and sex categories, seven coherent and consistent factors or eating styles emerged. These eating styles were entered into a multiple regression analysis to predict overeating frequency and body mass index (BMI). RESULTS: Each of the newly identified eating styles was independently related to self-reports of overeating frequency; five of the seven were significantly related to overweight and obesity. The eating styles include the following: (1) "Emotional Eating" (eating to manage feelings); (2) "Fresh Food, Fast Food" (eating mostly processed, high-calorie food; less fresh food); (3) "Food Fretting" (judgmental thoughts and overconcern about food); (4) "Task Snacking" (eating while doing other activities); (5) "Sensory, Spiritual Nourishment" ("flavoring" food with meaning); (6) "Eating Atmosphere" (dining aesthetics and surroundings); (7) "Social Fare" (eating alone vs with others). CONCLUSIONS: Further research is needed to assess the degree to which practicing and implementing these eating styles integratively will decrease overeating, overweight, and obesity.

Adult↗

Are family meal patterns associated with disordered eating behaviors among adolescents?

PURPOSE: To examine associations between family meal patterns (frequency, priority, atmosphere, and structure of family meals) and disordered eating (unhealthy weight control behaviors, binge eating, and chronic dieting) in adolescent girls and boys. METHODS: Survey and anthropometric data were collected from 4746 ethnically diverse adolescents from public middle and senior high schools who participated in the Project EAT study (Eating Among Teens). Variables of interest included family meal patterns and disordered eating behaviors. Logistic regressions were performed to examine associations between family meal patterns and disordered eating behaviors adjusting for body mass index, sociodemographic characteristics, family connectedness, and weight pressures within the home. RESULTS: In general, adolescents who reported more frequent family meals, high priority for family meals, a positive atmosphere at family meals, and a more structured family meal environment were less likely to engage in disordered eating. For example, 18.1% of girls who reported 1-2 family meals/week engaged in extreme weight control behaviors compared with 8.8% of girls who reported 3-4 family meals/week. Making family meals a priority, in spite of scheduling difficulties, emerged as the most consistent protective factor for disordered eating. Associations between family meal patterns and disordered eating behaviors tended to be stronger among girls than among boys. Family meal patterns were more consistently associated with unhealthy weight control behaviors than with chronic dieting and binge eating. Although associations between family meals and disordered eating were weakened after adjusting for more global familial factors, including family connectedness and weight-specific pressures within the home, a number of the associations remained statistically significant, suggesting an independent relationship between family meals and disordered eating. CONCLUSION: Family meals have the potential to play an important role in the prevention of unhealthy weight control behaviors among youth. Findings suggest that attention needs to be directed toward increasing family meal frequency and creating a positive environment for family meals.

Adolescent↗

Prevalence of abnormal eating attitudes and behaviors in hospital-based primary and tertiary care clinics: a window of opportunity?

OBJECTIVE: The "athletic triad" of amenorrhea, osteopenia, and eating disorders (EDs) has received increasing attention in the past decade. Adolescents may seek care for amenorrhea or other menstrual irregularity before disclosure of an eating disorder to a primary care clinician. The purpose of this study was to determine the prevalence of abnormal eating attitudes and behaviors in adolescent girls going to a clinic for reproductive endocrinology (RE) visits versus the prevalence in girls going for health maintenance (HM) visits. DESIGN: All patients aged 8-22 years going to RE or HM clinics were given a 26-item modified eating attitudes test (EAT) and two pages of questions on other eating issues and demographics. Informed consent was obtained from all participants, and also from the parents of those less than 18 years of age. SETTING: All subjects were seen at a hospital-based ambulatory (HM) or subspecialty (RE) clinic, with both clinics located on the same floor. PARTICIPANTS: The study included 53 girls from the RE clinic and 108 girls from the HM clinic. All demographics were similar except that the RE patients were slightly older and had significantly more parents with masters or doctorate degrees. MAIN OUTCOME MEASURES: Study variables were compared between RE and HM groups using either the Student's t test or the Chi-square test, with statistical significance defined as p < 0.05. A score of 20 or higher on the modified EAT was correlated with a high risk of EDs and was used as a measure of prevalence of abnormal eating attitudes and behaviors. RESULTS: Modified EAT scores were 11.8 +/- 8.9 in RE patients vs 7.0 +/- 7.2 in HM patients (p < 0.001), with 10 (18.9%) RE patients and 7 (6.5%) HM patients having scores of at least 20 (p = 0.016). No differences in daily exercise, dairy consumption, or use of vomiting or laxatives to control weight were found. As expected, RE patients were significantly more likely to experience menstrual irregularities than the HM patients (p < 0.001). CONCLUSIONS: Adolescents attending a reproductive endocrinology clinic showed a higher prevalence of abnormal eating attitudes and behaviors than did those going to a clinic for HM visits. Early detection of eating disorders may occur both within and outside of the primary care setting through use of a modified EAT.

Adolescent↗

Energy exchanges associated with eating and rumination in sheep given grass diets of different physical forms.

1. Energy exchanges and other physiological functions associated with eating and rumination were determined in four experiments. Sheep were given chopped, dried grass (DGC), pelleted, dried grass (DGP) or fresh grass (FGC). 2. In Expt I a preliminary study was made using all three diets. The dry matter (DM) of DGP was eaten significantly faster than that of chopped diets. Sheep salivated most during eating and ruminated longest when given DGC. Rates of contraction for the reticulo-rumen did not differ significantly between diets during idling and rumination, but were significantly faster during eating with DGP. The apparent energy costs of eating were 17, 109 and 176 kJ/kg DM eaten for DGP, DGC and FGC respectively, but these probably underestimated the true energy cost. 3. Expt 2 compared DGP and DGC at two levels of intake. The mean energy costs of eating DGP and DGC were 23.5 and 267 kI/kg DM respectively. The mean energy costs of eating between the energy cost of eating and the duration of the meal. The proportion of time the sheep spent ruminating DGC was about 23% but less than 1% for DGP. There was no significant relationship between heat production and the time spent ruminating. 4. In Expt 3 four sheep were offered fresh grass and, later, an equivalent DM intake after the material had been dried. The sheep ate the dried meal significantly faster. The mean energy costs of eating were 208 and 346 kJ/kg DM for DGC and FGC respectively. In this experiment the sheep ruminated significantly longer when given FGC, and the energy cost of rumination was 0.11 kJ/min. 5. Increases in heat production during and after fistula-feeding only 2-8% of those obtained during eating, indicating that nearly all the increase in heat production during eating could be attributed to the energy cost of eating per se. 6. The contribution of the energy costs of eating and rumination to the heat increment of feeding and the energy requirement for maintenance of sheep are discussed.

Animal Feed↗

Prevalence and correlates of binge eating in a nonclinical sample of women enrolled in a weight gain prevention program.

OBJECTIVES: The aims of the present study were to examine the prevalence and correlates of binge eating in a nonclinical sample of women and to examine whether associations differed by overweight status. DESIGN: Cross-sectional comparison of women based on self-reported binge eating status (large amount of food eaten and feelings of lack of control during these eating episodes) and overweight status (measured body weight: overweight defined as body mass index (BMI) > or = 27.3 kg/m2). PARTICIPANTS: Subjects were 817 women aged 20-45y from the community who enrolled in a three year prospective intervention study to examine methods for preventing age-related weight gain. MEASURES: Body weight was measured at baseline and three-year follow-up. Self-report measures of binge eating, dieting practices, eating and exercise behaviours, depression, self-esteem and stressful life events were collected at the three-year follow-up. RESULTS: The prevalence of binge eating in the past six months was 9% among normal weight women and 21% among overweight women. The frequency of binge eating was low (> 50% of binge eaters binged less than once per week) and did not significantly differ by body weight status. Compared to non-binge eaters, binge eaters reported more dieting practices, more extreme attitudes about weight and shape, and higher levels of depression and stressful life events. Binge eating was not related to habitual eating and exercise behaviours. In multivariate models, weight/shape importance (odds ratio (OR) = 3.33; 95% confidence intervals (95% CI) = 2.10, 5.29), depression (OR = 1.73; 95% CI = 1.07, 2.79) and history of intentional weight loss episodes (OR = 1.68; 95% CI = 1.03, 1.13) were independently associated with increased odds of binge eating. CONCLUSIONS: Binge eating is about twice as prevalent among overweight women, compared to normal weight women, in a nonclinical sample, but has similar correlates (that is, dieting, depression, weight/shape preoccupation). Prospective research is needed to determine whether there are causal associations between binge eating, depression, dieting and weight gain.

Adult↗

Prevalence and long-term course of lifetime eating disorders in an adult Australian twin cohort.

OBJECTIVE: Few studies exist that have examined the spectrum and natural long-term course of eating disturbance in the community. We examine the lifetime prevalence and long-term course of anorexia nervosa (AN), bulimia nervosa (BN) and eating disorder not otherwise specified (EDNOS) in an adult female twin population. METHOD: Female twins (n = 1002) from the Australian Twin Registry, aged 28-39 years, were assessed using the Eating Disorder Examination, revised to yield lifetime diagnostic information. For women with lifetime eating disorders, the assessment occurred, on average, 14.52 years (SD = 5.65) after onset of their disorder. RESULTS: In accordance with other community studies, we found a 1.9% lifetime prevalence of AN, with an additional 2.4% who met the criteria for 'partial AN' (absence of amenorrhea). Criteria for BN were met by 2.9% of the women, an additional 2.9% of women met criteria for binge eating disorder, while 5.3% met criteria for purging disorder unaccompanied by binge eating (EDNOS-p). Eleven (7%) of the women with lifetime eating disorders had a current eating disorder. Each diagnostic group continued to be differentiated by current eating pathology from women without lifetime eating disorders. Although approximately 75% of the women had a good outcome, less than 50% of each diagnostic group was asymptomatic. CONCLUSIONS: Eating disorders tend to improve over time often reaching subdiagnostic levels of severity, but only a minority of sufferers becomes asymptomatic. The DSM-IV diagnosis EDNOS needs to be considered in studies of the prevalence and course of eating disorders.

Adult↗

Partial eating disorders in a community sample of female adolescents.

OBJECTIVES: To evaluate the validity of two definitions of partial eating disorders, the Eating Attitudes Test (EAT) and a combination of the EAT and relevant criteria of the DSM-III-R, and to examine their association with factors related to anorexia nervosa and bulimia nervosa. METHOD: Questionnaires on eating behaviors, depression, obsessionality, and impulsivity were distributed to 534 female high school students. Demographic, psychosocial, and physical parameters and the subjects' height and weight were also recorded. RESULTS: EAT scores revealed maladaptive behaviors in 18% of the subjects: the combination of the EAT and DSM-III-R criteria identified 20.8% of the subjects as having partial anorexia nervosa and 11.3% as having partial bulimia nervosa. Both definitions were significantly associated with risk factors for clinical eating disorders: high weight, weight fluctuations, dieting, menstrual disturbances, high level of depression and obsessionality, and preoccupation with eating in the family. Partial bulimics fared worse on most of these parameters. Partial anorectics were not more psychologically distressed than normal subjects. CONCLUSIONS: The validity of both definitions of partial eating disorders is supported by their similar and significant associations with known risk factors for the development of the clinical syndromes. Partial bulimics are similar to patients with bulimia nervosa in the level of many eating-related disturbances and in depression, obsessionality, and impulsivity. Partial anorectics, like anorectic patients in clinical settings, tend to minimize their problems. The relevance of partial eating disorders to the later development of the full-blown clinical entity is still not established.

Adolescent↗

Longitudinal relationships between childhood, adolescent, and adult eating disorders.

OBJECTIVE: This study investigates the longitudinal course of eating problems from childhood though adulthood. The following questions are answered: (1) How stable are eating disorder symptoms and diagnoses over a 17-year interval from childhood to adulthood? (2) Do early childhood eating problems predict the occurrence of eating disorders in adulthood? METHOD: An epidemiologically selected sample of approximately 800 children and their mothers received DSM-based structured psychiatric assessments in 1975, 1983, 1985, and 1992. The stability of full DSM diagnostic criteria for anorexia nervosa and bulimia nervosa, symptom scales derived from DSM criteria, and individual symptoms such as binge eating or dieting between early adolescence, late adolescence, and young adulthood was examined. RESULTS: Early adolescent bulimia nervosa is associated with a 9-fold increase in risk for late adolescent bulimia nervosa and a 20-fold increase in risk for adult bulimia nervosa. Late adolescent bulimia nervosa is associated with a 35-fold increase in risk for adult bulimia nervosa. Symptom scale scores for anorexia nervosa and bulimia nervosa correlate in the 0.3 to 0.5 range from early to late adolescence and young adulthood. For both anorexia nervosa and bulimia nervosa, gender, as well as eating symptoms at early and late adolescence, all predict young-adult eating disorder symptoms. Risk factors for the later development of eating disorders comprise eating conflicts, struggles with food, and unpleasant meals in early childhood. CONCLUSION: The presence of eating problems in early childhood or an eating disorder in adolescence confers a strong risk for an eating disorder in young adulthood.

Adolescent↗

Prevalence of eating disordered behavior in collegiate lightweight women rowers and distance runners.

OBJECTIVE: This study examined eating behavior in collegiate women lightweight rowers, runners, and controls. It was hypothesized that rowers would show an increased prevalence of restraint in their eating behaviors, but not probable eating disorder cases as compared with runners or controls, because they are required to make their target weight but are discouraged from further weight loss. DESIGN: Retrospective survey. SETTING/PARTICIPANTS: Lightweight women rowers (n = 122) at eastern collegiate championship regattas, collegiate distance runners (n = 79) at a regional track meet, and a convenience sample of collegiate controls (n = 95) were surveyed. MAIN OUTCOME MEASURE: The Eating Disorders Examination-Questionnaire, a validated questionnaire evaluating eating attitudes and behaviors, and additional questions regarding weight and menstrual history were used to assess probable eating disorder cases and disordered eating tendencies. RESULTS: Rowers showed significantly more restraint in eating patterns during the previous month and less shape concern than either runners or controls. Rowers also reported increased use of diuretics. There were no significant differences between groups in terms of probable cases of eating disorders or disordered eating behavior. CONCLUSIONS: Lightweight rowing and distance running were not associated with increased prevalence of eating disorders in this sample, although rowing was associated with increased restraint and diuretic misuse. This use of pathologic weight-making behaviors is of significant clinical concern. These results support ongoing monitoring of disturbed eating and weight-making practices in weight-dependent sports, but do not support discouraging the growth of lightweight women's rowing at the collegiate level.

Adolescent↗

Childhood adversities associated with risk for eating disorders or weight problems during adolescence or early adulthood.

OBJECTIVE: A community-based prospective longitudinal study was conducted to investigate the association between childhood adversities and problems with eating or weight during adolescence and early adulthood. METHOD: A community-based sample of 782 mothers and their offspring were interviewed during the childhood, adolescence, and early adulthood of the offspring. Childhood maltreatment, eating problems, environmental risk factors, temperament, maladaptive parental behavior, and parental psychopathology were assessed during childhood and adolescence. Eating disorders and problems with eating or weight in the offspring were assessed during adolescence and early adulthood. RESULTS: A wide range of childhood adversities were associated with elevated risk for eating disorders and problems with eating or weight during adolescence and early adulthood after the effects of age, childhood eating problems, difficult childhood temperament, parental psychopathology, and co-occurring childhood adversities were controlled statistically. Numerous unique associations were found between specific childhood adversities and specific types of problems with eating or weight, and different patterns of association were obtained among the male and female subjects. Maladaptive paternal behavior was uniquely associated with risk for eating disorders in offspring after the effects of maladaptive maternal behavior, childhood maltreatment, and other co-occurring childhood adversities were controlled statistically. CONCLUSIONS: Childhood adversities may contribute to greater risk for the development of eating disorders and problems with eating and weight that persist into early adulthood. Maladaptive paternal behavior may play a particularly important role in the development of eating disorders in offspring.

Adolescent↗

Surgical management of obese patients with eating disorders: a survey of current practice.

BACKGROUND: This study examined the current practice of bariatric surgeons and their colleagues regarding patients with binge eating disorder (BED) and night eating syndrome (NES) who present for Roux-en-Y gastric bypass (RYGBP) for obesity. METHOD: We conducted a 9-item internet survey of American Society for Bariatric Surgery (ASBS) members. For each item, the numbers of respondents endorsing each possible response, including "Other" and "Unknown or not applicable," were tabulated, and percentages of the total sample of respondents were calculated. RESULTS: Most respondents' screening process included mental health (82.0%) and nutritional (78.0%) evaluations. Most inquired about binge eating (88.0%) and other eating disturbances (83.3%), while fewer respondents (52.7%) screened for night eating. Management of patients with eating disorders varied widely. For patients with binge eating, 20.0% of respondents proceeded with surgery, 2.7% recommended against surgery, and 27.3% postponed surgery, with the remainder (50.0%) reporting that their management varied. For night eating and other eating disturbances, responses were similarly diverse. Respondents who postponed surgery reported a wide range of estimates of how often patients with eating disorders follow through with treatment for their eating problem and return for surgery: 16% (always/almost always), 36% (usually), 24% (sometimes), 12% (occasionally), and 12% (never/almost never). CONCLUSION: Although bariatric surgeons commonly screen for eating disorders such as BED, there are limited empirical data and no consensus regarding the optimal management of these patients.

Bulimia↗

Prevalence of eating disorders and psychiatric comorbidity in a clinical sample of type 2 diabetes mellitus patients.

BACKGROUND: A few studies have shown high rates of eating disorders and psychiatric morbidity in patients with type 2 diabetes mellitus. OBJECTIVE: Disturbed eating behavior and psychiatric comorbidity in a sample of T2DM patients. METHODS: Seventy type 2 diabetes mellitus patients between 40 and 65 years of age (mean, 52.9 +/- 6.8) from a diabetes outpatient clinic were sequentially evaluated. The Structured Clinical Interview for DSM-IV, Binge Eating Scale and Beck Depression Inventory were used to assess eating disorders and other psychiatric comorbidity. In addition to the descriptive analysis of the data, we compared groups divided based on the presence of obesity (evaluated by the body mass index) or an eating disorder. RESULTS: Twenty percent of the sample displayed an eating disorder. Binge eating disorder was the predominant eating disorder diagnosis (10%). Overall, the group of obese patients with type 2 diabetes mellitus presented rates of psychiatric comorbidity comparable to those seen in their nonobese counterparts. However, the presence of an eating disorder was associated with a significant increase in the frequency of anxiety disorders (57.1% x 28.6%; p = 0.044). CONCLUSIONS: In our study sample, the occurrence of eating disorders was increased compared to rates observed in the general population, with the predominance of binge eating disorder. The presence of an eating disorder in type 2 diabetes mellitus patients was associated with higher rates of anxiety disorders.

Adult↗

Clinical and polysomnographic features of sleep-related eating disorder.

BACKGROUND: Sleep-related eating disorder is a recently described clinical syndrome that combines characteristics of both eating and sleep disorders. Nocturnal partial arousals are followed by rapid ingestion of food and subsequent poor memory for the episode. Only two case series examining this disorder have been published, and both are from the same sleep disorders center in a general hospital. METHOD: The author describes 23 consecutive cases of sleep-related eating disorder that presented to the Sleep Disorders Center at McLean Hospital. All patients were administered at a standardized clinical sleep disorders evaluation followed by a semistructured interview to elicit information regarding characteristics of sleep-related eating disorder. Polysomnographic evaluation was performed on all patients with clinical histories of sleep-related eating disorder. RESULTS: Eighty-three percent (N = 19) of the 23 patients were female. For most of the patients, the disorder had begun in adolescence (mean +/- SD = 21.6 +/- 10.9 years) and had been chronic, with a mean duration of 15.8 +/- 11.2 years. Nearly all patients reported eating on a nightly basis (1-6 times per night), and all episodes followed a period of sleep. All patients described their eating as "out of control," and two thirds stated that they "binged" during the night. Over 90% (21/23) reported their state at the time of nocturnal eating as "half-awake, half-asleep" or "asleep", and over 90% reported "consistent" or "occasional" amnesia for the event. Nearly half (11/23) of the sample were given a polysomnographic diagnosis of somnambulism. Thirty-five percent (8/23) had a lifetime eating disorder diagnosis. CONCLUSION: Sleep-related eating disorder appears to be a relatively homogeneous syndrome combining features of somnambulism and daytime eating disorders. However, no current nosology accurately characterizes these patients. Physicians should be aware of the existence of the disorder and the value of referring patients with sleep-related eating disorder to a sleep disorders center.

Adult↗

Disordered eating attitudes and behaviours in teenaged girls: a school-based study.

BACKGROUND: Disordered eating attitudes and behaviours are common in older teens and young women in Western countries. Recent evidence suggests that the prevalence of these disorders is rising and that the age of onset has fallen. In the present study, disturbed eating attitudes and behaviours were evaluated in a large school-based population in Ontario in order to determine their prevalence and demographic distribution. METHODS: Females, aged 12-18 years, from schools in Toronto, Hamilton and Ottawa were invited to complete questionnaires, including 3 subscales of the Eating Disorder Inventory (Drive for Thinness, Body Dissatisfaction, Bulimia), the Eating Attitudes Test-26 (EAT-26) and the Diagnostic Survey for Eating Disorders (DSED). RESULTS: Questionnaires were completed by 1739 (70%) of the 2483 adolescent females who were approached. The mean age of subjects in the sample was 14.6 (standard deviation 1.9) years. Thirteen percent of those aged 12-14 years and 16% of those aged 15-18 years had scores above the recommended cut-off (> or = 20) for disordered eating on the EAT-26. Current dieting to lose weight was reported by 23% of participants. Binge eating with associated loss of control was reported by 15% of participants, self-induced vomiting by 8.2% and the use of diet pills by 2.4%. Laxative and diuretic misuse were uncommon. Dieting was associated with an increased risk of binge-eating and purging behaviours. Older age and body mass index in the highest quartile were independently related to symptoms of eating disorders. INTERPRETATION: Disordered eating attitudes and behaviours were present in over 27% of girls aged 12-18 years and were seen to increase gradually throughout adolescence. Prevention programs to diminish the progression and impact of these disorders should be implemented and assessed.

Adolescent↗

Determinants of healthy eating in Canada: an overview and synthesis.

This article uses a population health perspective to examine the complex set of interactions among the determinants of healthy eating. An overview of current knowledge on determinants of healthy eating was organized as follows: 1) individual determinants of personal food choices and 2) collective determinants, including a) environmental determinants as the context for eating behaviours and b) public policies as creating supportive environments for healthy eating. A conceptual synthesis of the literature revealed that individual determinants of personal food choice (physiological state, food preferences, nutritional knowledge, perceptions of healthy eating and psychological factors) are necessary, but not sufficient, to explain eating behaviour, which is highly contextual. Collective determinants of eating behaviour include a wide range of contextual factors, such as the interpersonal environment created by family and peers, the physical environment, which determines food availability and accessibility, the economic environment, in which food is a commodity to be marketed for profit, and the social environment, in which social status (income, education and gender) and cultural milieu are determinants of healthy eating that may be working "invisibly" to structure food choice. Policy is a powerful means of mediating multiple environments. There are gaps in our understanding of the process of intervening in macro-level environments and the impact of such interventions on the promotion of healthy eating. Collective determinants of food choice and policy contexts for promoting healthy eating, therefore, require investment in research. Applying a population health promotion lens to understanding the multiple contexts influencing healthy eating provides insight into prioritizing research and action strategies for the promotion of healthy eating.

Adolescent↗

Eating pathology in bulimia nervosa.

Degree of eating pathology in bulimia nervosa was assessed using the Eating Behavior Rating Scale (EBRS) across three videotaped eating sessions. Twelve bulimic and 12 non-eating disordered subjects participated in this study. All subjects were filmed during a baseline meal (ad libitum), a high-calorie meal, and a low-calorie meal (both fixed amounts). Mean EBRS scores were significantly higher for bulimics (12.6 +/- 1.7) than for controls (3.9 +/- 0.9), suggesting a higher degree of eating pathology in these patients. Affect during eating was significantly more negative in the bulimic patients. EBRS and affect scores were significantly correlated [r (11) = .813, p < .01]. Bulimics had a slower rate of eating than controls and took significantly longer to initiate eating. Scores of pathological eating correlated with scores on the Eating Attitudes Test and the Bulimic Investigatory Test-Edinburgh, indicating a relationship between objective measures of pathological eating and self-report measures of eating disorder symptoms.

Adult↗

Nighttime eating: a descriptive study.

OBJECTIVE: The definition of night eating syndrome (NES) is inconsistent across various studies and literatures. The goal of the current descriptive study was to collect data on participants who were selected using broad criteria for nighttime eating. Researchers have cogently argued for consideration of wide ranges including "subsyndromal" cases before reifying diagnostic constructs prematurely. METHOD: One-hundred six participants with broadly defined nighttime eating problems were recruited through newspaper advertisements and were interviewed over the phone. The following instruments were administered: the Night Eating Questionnaire, the Night Eating Syndrome History and Inventory, the Eating Disorder Questionnaire, the Structured Clinical Interview for DSM-IV diagnoses and a Sleep Disorder Questionnaire. RESULTS: Thirty-one (29.2%) participants met the original criteria described by Stunkard et al. (Am J Med 1955;19:78) and only 14 (13.2%) participants met all of the most recent proposed criteria for NES (Birketvedt et al., JAMA 1999;282:657). The overlap between binge eating disorder (BED) and nighttime eating problems was modest in our sample with only 9 participants meeting current BED criteria. One half of our sample was obese. Regular nocturnal eating was reported by 57.5% of the participants. Dieting was not a frequent precursor or antecedent of nocturnal eating. However, self-reported current parasomnias were quite frequent in our sample. CONCLUSION: Our descriptive study confirms some of the observations made by other researchers. Nevertheless, nighttime eating is still an evolving concept that requires close collaboration between eating and sleep researchers.

Anorexia↗

Executive personality traits and eating behavior.

Eating disorders, such as anorexia, bulimia, and binge eating disorder, commonly involve a dysregulation of behavior (e.g., a lack or excess of inhibition and impulsive eating patterns) that is suggestive of prefrontal dysfunction. Functional neuro-imaging studies show that prefrontal-subcortical systems play a role in eating behavior and appetite in healthy individuals, and that people with eating disorders have altered activity in these systems. Eating behavior is often disturbed by illnesses and injuries that impinge upon prefrontal-subcortical systems. This study examined relationships between executive functioning and eating behavior in healthy individuals using validated behavioral rating scales (Frontal Systems Behavior Scale and Eating Inventory). Correlations demonstrated that increased dysexecutive traits were associated with disinhibited eating and greater food cravings. There was also a positive association with cognitive restraint of eating, suggesting that increased compensatory behaviors follow disinhibited eating. These psychometric findings reinforce those of other methodologies, supporting a role for prefrontal systems in eating.

Adolescent↗