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PubMed2006

I see what you see: the lack of a self-serving body-image bias in eating disorders.

OBJECTIVES: Eating-disordered subjects feel unattractive, and the current idea is that this feeling reflects a distorted body image. A distorted body image requires a mismatch between the negative self-judgments and more objective judgments of the body. DESIGN AND METHODS: To examine whether eating-disordered subjects have valid reasons for their feelings of unattractiveness, the body images of eating-symptomatic subjects and control models were compared with inter-subjective evaluations of these bodies given by two community samples (panels; N=72, N=88). RESULTS: Although the objective body sizes of the eating-symptomatic subjects were in the normal range and not different from control bodies, the first panel rated the (headless) bodies of the eating-symptomatic subjects as less attractive. This finding was replicated with the second panel. There was also large agreement between the eating-symptomatic subjects and the second panel on the specific body parts that were indicated as unattractive. Contrary to the eating-symptomatic subjects, the control models showed a strong positively biased perception of their own attractiveness: they rated their own bodies more positively than others rated them. CONCLUSION: Consensual validation of the harsh body appraisals of eating-symptomatic subjects was found. Interestingly, the normal controls were the ones that showed a biased body image; they rated themselves far more attractive than other people rated them. These data suggest that the real problem in eating disorders is not a distorted body image but a lack of a distorted body image, that is, the lack of a self-serving body-image bias.

Adult↗

PubMed2003

Reliability and validity of a Japanese version of the Eating Disorder Inventory.

The rapid increase of patients with eating disorders in Japan has male necessary the reliable and valid measurement of psychological factors in eating disorders. The purpose of this study was to examine the reliability and validity of the Japanese version of the Eating Disorder Inventory. 766 females without eating disorders and 139 female patients with eating disorders responded to the Eating Attitude Test and the Eating Disorder Inventory. Principal factor extraction with promax rotation isolated 9 interpretable factors with satisfactory internal consistency (Cronbach alpha range=.74-.90). Compared with controls, patients scored significantly higher on all factors after minimizing the influence of Body Mass Index. There were strong correlations among factor scores and scores on the Eating Attitudes Test, particularly among patients. These results indicate the Eating Disorder Inventory as showing psychometrically sound internal consistency and concurrent validity.

Adolescent↗

PubMed1998

Energy requirement for eating in cattle.

We determined the energy requirement for the activity associated with eating in an experiment with four adult Hinterwälder steers weighing 640+/-25 kg BW (mean+/-SD), using indirect calorimetry in respiration chambers. Heat production was measured during 3 h with and 3 h without ad libitum access to wheat straw, and the energy cost of eating was calculated as the difference, which was on average 27+/-13 J/(min x kg BW) (mean+/-SD). Straw intake, the time spent for eating, and the number of jaw movements were recorded. Values for the energy cost of eating reported in the literature are similar to those in this study, and values for ruminating amount to approximately 27% of those for eating. The energy cost of eating (literature values) varies greatly between feeds and feed treatments, when related to the amount of feed ingested, but it was relatively constant when related to time spent eating and was similar for cattle, sheep, and horses, when related to BW or metabolic BW (35 J/[min x kg BW] or 124 J/ [min x kg BW.75]). Calculations indicated that in high-quality roughage 10% of the ME and in untreated straw approximately 30% of the ME provided by the feed are used for eating and ruminating. This might be the main reason for the lower efficiency of ME utilization in roughages. The energy requirement for eating and ruminating should therefore be considered as a distinct proportion of the total ME requirement.

Animal Feed↗

PubMed2002

College women: eating behaviors and help-seeking preferences.

Late adolescent women at a large, mid-Atlantic university were surveyed. Of the 578 who completed the survey, 17% were found to have eating disorders as defined by a score of 20 or above on the Eating Attitudes Test (EAT-26; Garner, Olmstead, Bohr, & Garfinkel, 1982). Participants who scored 20 or above were younger and more likely to be white, in a sorority, and Christian than were those who scored below 20 on the EAT-26. No correlation was found between EAT-26 scores and participation in organized athletics. In addition, the participants were asked about their choice of help and support should they have any worries about their eating. They were most likely to say that they would prefer a close friend to support them when dealing with disordered eating, followed by their parents and their significant other. In terms of professional services, most women reported that they would prefer individual assistance such as a consultation with a physician, a nutritionist, or a therapist, followed by family therapy, if they ever had questions about eating or thought they needed professional help with disordered eating.

Adolescent↗

PubMed2002

[Eating disturbances in adolescent girls with type 1 diabetes mellitus].

Eating disorders that meet DSM-IV criteria, especially bulimia nervosa and EDNOS are more than twice as common in adolescent girls with Type 1 Diabetes (DM) than in their nondiabetic peers. The prevalence of subthreshold eating disorders is especially high in this group and may be found in 14% of girls with DM. Insulin omission is a common weight loss behavior in girls with DM and eating disorders. Insulin omission and binge eating inevitably contribute to the increased rate of hyperglycemia and increased risk of long-term diabetes related medical complications, including retinopathy and nephropathy. The weight gain and dietary restrictions associated with diabetes treatment and the ready availability of insulin omission to promote weight loss are most likely responsible for this increased prevalence of eating disorders. A high index of suspicion for eating disorders is recommended in the diabetes clinic setting to enable early identification of disordered eating attitudes and behavior before they progress to clinical eating disorders. Clinic-based psychoeducational programs may be effective for prevention or early intervention. Severe eating disorders require more intensive intervention, tailored to address the DM context.

Adolescent↗

PubMedDate not supplied

[Comorbidity of obesity and eating behavior disorders].

UNLABELLED: In the few years various factors that influence obesity have been studied, including genetic, sociocultural, metabolic and endocrine factors. Research advances in this area will help enhance our knowledge, prevention and treatment of this syndrome. OBJECTIVE: Our first aim is to establish comorbidity between obesity and eating disorders (i.e., binge eating disorder, compulsive overeating disorder and bulimia). Our second aim is to establish the relation between psychiatric diagnoses and sociodemographic, anthropometric, endocrine and psychological variables. METHOD: We interviewed 97 outpatients that attended a specialized clinic for obesity control in Mexico City, 67 females and 30 males. These patients were interviewed by a nutrition specialist, an endocrinologist and a psychiatrist, all working in the obesity clinic. For the psychiatric diagnoses, DSM-IV criteria were applied to analyze the clinical information on the charts. RESULTS: Of all patients in the group 13.4% presented no psychiatric disorder, 53.6% met criteria for binge eating disorder, 12.4% for type six NOS-ED (Not Otherwise Specified Eating Disorder) (compulsive overeating) and 20.6% for bulimia. Endocrine disorders were found as follows: 80.4% presented no endocrine disorder, 11.3% diabetes mellitus, and 8.2% other diagnoses. Obesity degree: 8.2% normal weight, 28.9% overweight, 37.1% type 1 obesity, 18.6% type II obesity and 7.2% extreme obesity; binge eating disorder was related to all obesity types. Bulimic patients had a greater energetic expenditure. Patients with psychiatric disorders generally did not present endocrine comorbidity, only 13.4% comorbidity. The number of treatments to reduce weight was in direct relationship to patients with psychiatric disorders. Patients with a largest calorie intake presented binge eating disorder with more eating periods per hay. In sum, by measuring anthropometric variables and some nutritional variables, such as the way of eating and calorie intake, it was easier to predict eating disorders in obese patients. The medical variables themselves were not associated to the mental health of obese patients. CONCLUSIONS: We found there is an important relation between obesity and psychiatric disorders and we consider it necessary to undertake further multidisciplinary, longitudinal and prospective studies in other groups of patients or non patients.

Adolescent↗

PubMed2006

[Etiology and treatment of eating disorders in adolescents: a report of 6 cases].

The occurrence of eating disorders in Chinese adolescents is increasing. However the cause, diagnosis, treatment and prognosis of this disorder are rarely reported by pediatricians. This paper investigated the cause and treatment of six cases of eating disorders in adolescent patients. The medical data of six cases of eating disorders in the Shanghai Children's Medical Center from January 2003 to September 2005 were retrospectively reviewed. The patients were 5 girls and 1 boy, whose onset ages ranged from 12.4 to 15.8 years. They were initially referred to the clinic between 12.9 to 16.7 years, with a course of disease varying from three to twelve months. The patients' body mass index (BMI) varied from 9.07 to 17.0. Four out of the six patients were hospitalized because of low temperature, low blood pressure, bradycardia, dehydration and multiple systems damages. The other two were treated in the out-patient clinic. Based on the medical history and physical examination as well as laboratory findings, five of them were diagnosed with anorexia nervosa and the other one were bulimia nervosa. All of the patients were under the care of a team consisting of pediatricians, dietitians, psychiatrists and nurses. When the patients whose vital signs were unstable, medical treatment focused on life sustention and they were kept on beds compulsively and given nutrition transfusion. Meanwhile cognition and behavior therapy was administered to help the patients find out the internal and environmental factors related to the development of this disorder, establish a new conception of healthy weight, and correct their abnormal eating behaviors. The patients who had a severe distortion of body image and a big resistance to the treatment were additionally administered with psychiatry drugs. After treatment, three patients set up a healthy eating behavior, their body weights gradually recovered and they had no relapse during a 1-year follow-up. The other three patients retained some abnormal eating behaviors and their body weights were always below normal. It was found that eating disorders in adolescents may be triggered by some environmental factors, such as comments on body shape from their peers, fashion influence, academic pressures, and problems in communication. Since the patients' abnormal eating behaviors were masked or neglected by parents at the early stage of the disease and the clinical presentations were related to multiple systems, it is difficult to make an early diagnosis and treatment. It is important to improve the pediatricians' knowledge of eating disorders of adolescents and perform cooperation between a multidisciplinary team for the early diagnosis and treatment of this disorder.

Adolescent↗

PubMed1993

Additional categories of sleep-related eating disorders and the current status of treatment.

Sleep-related eating disorders distinct from daytime eating disorders have recently been shown to be associated with sleepwalking (SW), periodic limb movement (PLM) disorder and triazolam abuse in a series of 19 adults. We now report eight other primary or combined etiologies identified by clinical evaluations and polysomnographic monitoring of 19 additional adults (mean age 40 years; 58% female): i) obstructive sleep apnea (OSA), with eating during apnea-induced confusional arousals (n = 3); ii) OSA-PLM disorder (n = 1); iii) familial SW and sleep-related eating (n = 2); iv) SW-PLM disorder (n = 1); v) SW-irregular sleep/wake pattern disorder (n = 1); vi) familial restless legs syndrome and sleep-related eating (n = 2); vii) anorexia nervosa with nocturnal bulimia (n = 2) and viii) amitriptyline treatment of migraines (n = 1). In our cumulative series of 38 patients (excluding six with simple obesity from daytime overeating), 44% were overweight (i.e. > 20% excess weight) from sleep-related eating. Nightly sleep-related binge eating (without hunger or purging) had occurred in 84% of patients. Onset of sleep-related eating was also closely linked with i) acute stress involving reality-based concerns about the safety of family members or about relationship problems (n = 6), ii) abstinence from alcohol and opiate/cocaine abuse (n = 2) and iii) cessation of cigarette smoking (n = 2). Current treatment data indicate a primary role of dopaminergic agents (carbidopa/L-dopa; bromocriptine), often combined with codeine and clonazepam, in controlling most cases involving SW and/or PLM disorder. Fluoxetine was effective in two of three patients. Nasal continuous positive airway pressure therapy controlled sleep-related eating in two OSA patients.

Adult↗

PubMed1989

Eating behavior of women with bulimia.

To obtain objective information about binge- and non-binge-eating behavior, 12 women with bulimia and ten women without eating problems (controls) were asked to eat four meals in a structured laboratory setting, on separate nonconsecutive days. The same instructions were given to both groups. On two days, they were asked to eat a normal amount, and on two days, they were asked to eat as much as they could, ie, to binge. For each type of instruction, they were given a single- and a multiple-course meal. The patients ate significantly more than the controls when asked to binge, both on the multiple-course meals that they rated as typical of binges and on the single-course meals. When they were asked to eat normally, there was no significant difference in intake between patients and controls on either single- or multiple-course meals. After all meals, hunger ratings of patients were significantly higher than hunger ratings of controls. There was also a significant positive correlation between intakes of single- and multiple-course binge meals and an inverse correlation between intake of multiple-course binge meals in bulimic patients and their rating of how well they controlled their eating. Thus, a structured laboratory eating situation can be used to reveal differences between bulimic and normal individuals and has the potential for assessing clinical status and exploring mechanisms responsible for binge eating.

Adult↗

PubMed1996

Food preferences and desire to eat in anorexia and bulimia nervosa.

OBJECTIVE: To determine whether eating disordered patients and controls differ in visual analog scale (VAS) ratings of liking and desire to eat various foods and whether ratings differ according to caloric or macronutrient content of the foods. METHOD: Fifty-five female inpatients with eating disorders and 15 controls rated their liking of and desire to eat 50 common foods at admission and discharge using 100-mm VAS. RESULTS: All patient groups rated their desire to eat high-calorie foods significantly lower than their desire to eat low-calorie foods whereas controls rated their desire to eat high- and low-calorie foods equally. Patients also differed from controls more in ratings of desire to eat than in liking when foods were classified according to macronutrient content. In restricting anorexics (N = 25), ratings of liking and desire to eat for high-fat/low-carbohydrate (CHO) and high-fat/high-CHO foods were not significantly correlated at admission. Disparity in correlations between restrictors, bulimics (N = 18), and controls was attenuated with treatment while anorexics with bulimic features (N = 12) became less like controls from admission to discharge. DISCUSSION: Differences in the way patients and controls perceive foods should be borne in mind during the treatment process. Furthermore, since patients had not completely normalized by discharge, treatment strategies should emphasize acceptance of foods varying in macronutrient and caloric content, as intake of a varied diet is of key importance in regaining and maintaining good health.

Adult↗

PubMed1995

Binge eating in massively obese patients undergoing bariatric surgery.

Data on the prevalence of binge eating in a series of 92 massively obese patients undergoing bariatric surgery are presented. A semistructured clinical interview demonstrated that 63 individuals had problems with binge eating, 43 of these reporting episodes of binge eating more than twice a week and then meeting the diagnostic criteria for binge eating disorder. By comparison with their nonbinge eating counterparts, binge eaters demonstrated higher body weight, greater weight fluctuation due to reducing diets in their past lifetime, higher Three-Factor Eating Questionnaire Disinhibition and Hunger score, and an overall higher psychopathology as assessed by the Eating Disorder Inventory. The great prevalence of binge eating in these patients could be accounted for by the high body weight, by the characteristics of the patients, or by the context in which the eating behavior assessment was carried out.

Adolescent↗

PubMed2003

Binge eating in children and adolescents.

OBJECTIVE: To establish what is known about binge eating in children and adolescents and to identify unresolved questions. METHOD: We reviewed relevant studies to highlight and synthesize salient research findings. DISCUSSION: Available research has suggested that loss of control over eating may be more important than consumption of an objectively large amount of food in the assessment of binge eating in children. In addition, dieting may not be associated consistently with binge eating in children. Behavioral correlates of binges may include eating in the absence of hunger, eating in response to strong emotions or external cues, and eating in secret. On the basis of available research, provisional research criteria for binge eating disorder (BED) in children are suggested to stimulate further study of pediatric samples. We emphasize the need for prospective studies on the relationships among aberrant eating, weight and mood, and the inclusion of boys and girls of different ethnicities.

Adolescent↗

PubMed2004

Daily stress, coping, and dietary restraint in binge eating.

OBJECTIVE: The current study evaluated whether psychological stress, use of specific coping strategies, and trait dietary restraint would prospectively predict binge eating episodes. METHOD: After completing a baseline measure of restraint, 46 binge eating college women kept daily diaries assessing depressed affect, stress, coping, and binge eating for 30 days. RESULTS: Regardless of level of depressed mood, higher stress was associated with increased risk of same-day binge eating; distraction coping was associated with increased risk of future binge eating; social support was associated with decreased risk of same-day binge eating; and women with high versus low dietary restraint showed different patterns of relationship for stress, coping, and binge eating. DISCUSSION: Vulnerability to binge eating in women who differ in terms of dietary restraint level may vary as a function of their coping responses to stress. Results highlight the complexities of stress and coping in binge eating.

Adaptation, Psychological↗

PubMed2006

Development of the eating disorder recovery self-efficacy questionnaire.

OBJECTIVE: The purpose of the current investigation was to develop and validate the Eating Disorder Recovery Self-Efficacy Questionnaire (EDRSQ), a self-report measure of self-efficacy to recover from an eating disorder. METHOD: Participants were 116 female patients with anorexia nervosa, bulimia nervosa, or a subthreshold eating disorder treated at an eating disorder clinic. Patients completed the EDRSQ and measures of eating disorder symptoms and depression. RESULTS: The EDRSQ contains two internally consistent factors, Normative Eating Self-Efficacy and Body Image Self-Efficacy. Moderate to large correlations between EDRSQ subscales and measures of eating disorder pathology support the convergent validity of the EDRSQ. The EDRSQ demonstrates theoretically consistent relations with constructs that are related to but distinct from self-efficacy. Discriminant validity is reflected in small correlations between EDRSQ subscales and measures of general psychological correlates of disordered eating. CONCLUSION: The EDRSQ is a psychometrically sound measure to assess self-efficacy in patients with a range of eating disorder diagnoses.

Adolescent↗

PubMed2006

Relations between dietary restraint, depressive symptoms, and binge eating: A longitudinal study.

OBJECTIVE: Temporal relations between dietary restraint, depressive symptoms, and binge eating were tested by means of three competing models positing that (1) dietary restraint and depressive symptoms predict future increases in binge eating, (2) binge eating predicts future increases in dietary restraint and depressive symptoms, and (3) binge eating is reciprocally related to these two factors. METHOD: Longitudinal data from a community sample of Dutch females (N = 143; M age = 19.6) was used to test these relations while controlling for initial levels of these factors. RESULTS: Dietary restraint did not predict future increases in binge eating, nor did binge eating predict future increases in dietary restraint. Depressive symptoms predicted future increases in binge eating, but binge eating did not predict future increases in depressive symptoms. CONCLUSION: Although this study had limited statistical power, the pattern of relations and effect sizes suggest that depressive symptoms, but not dietary restraint, increase risk of binge eating for late adolescent females.

Adolescent↗

PubMed2006

Eating Pattern Inventory for Children: a new self-rating questionnaire for preadolescents.

A questionnaire on psychological dimensions of eating behavior in children is presented. Existing questionnaires for children specifically focus on symptoms of eating disorders only, whereas for adults, questionnaires assessing general psychological dimensions of eating behavior are also available. The development of the Eating Pattern Inventory for Children (EPI-C) was based on a sample of 373 fourth-grade students. Factor and item analysis led to a psychometrically sound 20-item questionnaire with the dimensions dietary restraint, external eating, parental pressure to eat, and emotional eating. These factors explain 62% of the total item variance. Subscale scores and emerging eating patterns were associated with children's body weight suggesting initial evidence of its validity. The EPI-C is proposed for research on eating behavior in clinical and non-clinical preadolescent samples.

Body Mass Index↗

PubMed1993

Effects of ozone and nitrogen dioxide on drinking and eating behaviors in mice.

Male ICR mice were exposed continuously to ozone (O3) and nitrogen dioxide (NO2) for 7 days to examine the effects on drinking and eating behaviors. Ozone at 0.1 ppm did not affect drinking and eating activities, whereas drinking activity decreased in a concentration-dependent manner to 47.7, 12.8, and 3.0% of the control value with 2-day exposures to 0.2, 0.4, and 0.8 ppm O3, respectively, and eating activity decreased to 35.2 and 8.7% of the control value at 0.4 and 0.8 ppm O3, respectively. Body weight also decreased markedly by 2.0, 4.6, and 7.5 g at 0.2, 0.4, and 0.8 ppm O3, respectively. These decrements reached a maximum on the second day of exposure. However, alterations in drinking and eating activities and body weight were transient, leading to recovery during the continuous O3 exposures. The recovery processes were dependent on the concentrations of O3. Nitrogen dioxide at 4 ppm did not affect drinking and eating activities, whereas drinking activity decreased in a concentration-dependent manner to 56.8, 8.3, and 18.7% of the control value with 2-day exposures to 6, 8, and 12 ppm NO2, respectively, and eating activity decreased markedly to 21.8 and 16.4% at 8 and 12 ppm NO2, respectively. Body weight also decreased by 2.5, 5.5, and 6.1 g at 6, 8, and 12 ppm NO2, respectively. These decrements reached a maximum on the second day of exposure. As in the O3 exposures, the decrements in drinking and eating activities and body weight were transient and recovered during the continuous exposures to NO2 depending on the concentrations of NO2. Drinking and eating activities and body weights of mice that had been previously exposed to 12 ppm NO2 for 7 days did not show changes when the mice were exposed to 0.4 ppm O3 9 days after NO2 exposure. The present study demonstrates that photochemical oxidants suppress drinking and eating behaviors in mice and that they recover thereafter under the continuous exposure conditions.

Animals↗

PubMedDate not supplied

Use of sibutramine, an inhibitor of the reuptake of serotonin and noradrenaline, in the treatment of binge eating disorder: a placebo-controlled study.

Binge-eating disorder, which is characterized by repeated episodes of uncontrolled eating, is common in obese patients and is often accompanied by comorbid psychiatric disorders, especially depression. In previous studies, selective serotonin reuptake inhibitors have demonstrated efficacy in reducing the frequency of binge eating and addressing comorbid psychiatric disorders, but they have not shown the ability to promote weight loss. Sibutramine, a new serotonin and norepinephrine reuptake inhibitor, has been shown in short- and long-term studies to be effective in promoting and maintaining weight loss in obese patients who have binge-eating disorder. In this randomized, double-blind, placebo-controlled study, the efficacy, safety, and tolerability of sibutramine were evaluated in the treatment of binge-eating disorder in obese patients. Twenty patients were randomly assigned in equal numbers to receive either sibutramine 10 mg/day or placebo for 12 weeks. Assessments were made at baseline and every 2 weeks throughout the study. Binge frequency, defined as the number of days during the previous week that included binge-eating episodes, was the primary outcome measure. By the end of the study, the binge frequency among patients given sibutramine was significantly lower than that among those given placebo. The main adverse events in the sibutramine group were dry mouth and constipation. The findings suggest sibutramine is an effective medication in the treatment of binge-eating disorders and is well tolerated. In addition, it addresses the 3 main goals in the treatment of binge-eating disorder: reducing the frequency of binge eating, promoting and maintaining weight loss, and treating the comorbid psychiatric conditions.

Adult↗