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PubMed2006

Cognitive behavior therapy of binge eating disorder.

Binge eating disorder (BED) is characterized by recurrent episodes of uncontrollable eating, even when not hungry, until uncomfortably full, occurring at least twice a week for a 6-month period. This is differentiated from bulimia nervosa (BN) by the lack of compensatory mechanisms such as purging/laxative abuse. There are significantly higher levels of psychiatric symptoms in patients with BED as compared to those without BED. Furthermore, depressive symptomatology may increase the patient's vulnerability to binge eating as well as to relapse after treatment. Grazing is defined as eating small amounts of food continuously. BED in the pre-bariatric patient can manifest as 'grazing' about 2 years post-bariatric surgery. Treatment should be directed at eating behavior, associated psychopathology, weight and psychiatric symptoms. Cognitive behavior therapy is based on changing the patient's erroneous ways of thinking about themselves, the world and how others perceive them. This includes a focus on normalizing food intake as well as challenging dysfunctional thinking, identifying feelings, and developing non-food coping skills. It increases a sense of control and therefore helps the patient adhere to behavior change strategy, as well as improving mood and reducing associated psychopathology. Interpersonal therapy is based on the relationship between negative mood low self-esteem traumatic life events, interpersonal functioning and the patient's eating behavior. The rationale being that eating represents maladaptive coping with underlying difficulties. While psychotherapy either CBT or IPT leads to decrease in disordered eating behaviors and improved psychiatric symptoms, it has little effect on weight hence; its benefit is optimal when used in conjunction with bariatric surgery.

Bulimia Nervosa↗

PubMed1996

Eating and weight controlling behaviours of young ballet dancers.

Ballet dancers (n = 60) in full-time ballet training and school students (n = 216) completed questionnaires relating to body weight and eating behaviour. Dancers were at lower body weight and had less body fat. Dancers considered they were more preoccupied with thoughts of eating and body weight, felt they had greater difficulty controlling their body weight, used and abused laxatives for weight control, and reported disordered eating more than school students. Two-thirds of dancers and students were currently using at least one method of weight control, dancers favouring not eating between meals, and students exercise. Both groups reported binge eating and using multiple methods to control this behaviour. The pressure for dancers to be at below average weight affects their eating and weight controlling behaviours and their life-style. Young women such as dancers, gymnasts and some athletes are required to be at low body weight. These women maintain high levels of exercise. Whether ballet dancers are self-selected as they are genetically slim, control their body weight with the higher levels of exercise or need to employ strategies to maintain their low body weight, has not been clarified. A significant proportion of ballet dancers have been reported to have symptoms of anorexia nervosa and to be described as 'weight preoccupied'. It has also been suggested that the incidence of disordered eating is greater in women who are under pressure to maintain low body weight. The aim of this study is to compare the eating and weight losing behaviour, attitudes and anthropomorphic characteristics of young women in full-time ballet training and those who are not.

Body Weight↗

PubMed2002

Abuse, bullying, and discrimination as risk factors for binge eating disorder.

OBJECTIVE: This study examined whether sexual and physical abuse, bullying by peers, and ethnicity-based discrimination are associated with an increased risk for developing binge eating disorder in black women and in white women and whether any increase in risk is specific for the development of binge eating disorder. METHOD: A community sample of 162 women with binge eating disorder and 251 healthy and 107 psychiatric comparison subjects was interviewed for exposure to the risk factors under investigation. RESULTS: White subjects with binge eating disorder reported significantly higher rates of sexual abuse, physical abuse, bullying by peers, and discrimination than healthy comparison subjects. Only rates of discrimination were significantly higher in white women with binge eating disorder than in matched psychiatric comparison subjects. In black women with binge eating disorder, rates of sexual abuse, physical abuse, and bullying by peers-but not discrimination-were significantly higher than in healthy comparison women. Rates of sexual abuse were significantly higher in black women with binge eating disorder than in psychiatric comparison subjects. CONCLUSIONS: Consistent with previous research examining ethnicity-specific patterns of risk for psychiatric disorder, we found both ethnic similarities (physical abuse and bullying by peers) and differences (sexual abuse and discrimination) in the risk for binge eating disorder.

Adult↗

PubMed1997

Outcomes of individualized interventions in patients with severe eating difficulties.

The aim of this case study is to describe the outcomes of individualized interventions for patients with severe eating difficulties. The participants were 15 patients who had severe eating difficulties following a stroke or brain tumor and were receiving oral feeding or tube feeding. Interventions focused on training functions needed for eating, activities in eating, and discussions with the patient. Improvements were especially noted in eating activities, and some improvements were noted in oral movements and nutritional status. Before the interventions, none of the patients ate regular food; afterward, six did, and in four patients, the feeding tube was removed. The patients said eating was easier, and they could eat in a safe way. Furthermore, they appreciated the attention to their experience during meals. Although the impairments were not always alleviated, the patients found means to cope with their eating difficulties.

Activities of Daily Living↗

PubMed2006

Obsessive-compulsive beliefs and magical ideation in eating disorders.

OBJECTIVES: Similarities in patterns of cognition and behaviour between patients with eating disorders and those with obsessive-compulsive disorder (OCD) have long been recognized, and comorbidity between these disorders has been shown to be high. However, there has been little investigation of the cognitive content shared between eating disorders and OCD. It has been suggested that a cognitive analysis of the overlap between the disorders may help to increase understanding of each, and have potentially useful clinical implications. The present study aimed to investigate the presence of obsessive-compulsive beliefs and magical ideation (MI) in a group of eating-disordered participants. METHOD: One hundred seventy-seven volunteers with a history of or current eating disorder completed the Obsessive Beliefs Questionnaire (OBQ), the Interpretation of Intrusions Inventory (IlI) and the Magical ideation scale (MIS). RESULTS: Eating-disordered participants demonstrated levels of the beliefs measured comparable to or higher than those with OCD. CONCLUSIONS: The results supported the hypothesis that the belief domains investigated are relevant to eating-disordered individuals. This has interesting theoretical and clinical implications. Further research will be required to elucidate the role of these types of cognitions in the relationship between eating disorders and OCD, and to clarify their role in the psychopathology of eating disorders.

Adolescent↗

PubMed2002

Sweet eating is not a predictor of outcome after Lap-Band placement. Can we finally bury the myth?

BACKGROUND: It is common belief that sweet eaters will do poorly after gastric restrictive surgery. There is scant evidence for this and significant evidence that sweet eating behavior is not predictive of weight outcome. Preoperative and current sweet eating behavior was assessed in subjects who have had Lap-Band surgery, to find if this influenced weight outcomes. METHOD: 200 unselected patients who had bands inserted for > 1 year completed a questionaire regarding preoperative sweet eating behavior. The last 100 patients also reported current sweet eating behavior. Sweet eating was scored using a standard dietary questionnaire. RESULTS: Mean +/- SD % excess weight loss at 1 year (% EWL1) for the 100 with the highest preoperative sweet eating scores (SES) was 47.1 +/- 16% compared with a loss of 48.2 +/- 16% by those with the lowest SES (P = 0.64). Analysis showed no significant linear or non-linear correlation between the SES and the % EWL. For the highest quintile of SES, the EWL1 was 47.3 +/- 14% and for the lowest was 46.1 +/- 16% (NS). Sweet eaters were younger (r = -0.21, P = 0.003) and had higher fasting insulin concentrations (r = -0.18, P = 0.03). Preoperative SES had no influence on % EWL1 after controlling for factors known to influence weight loss. % EWL at 2 years (n = 130) and 3 years (n = 88) were not different for sweet eaters and non-sweet eaters. Current sweet eating tendency (n = 100) also had no impact on % EWL. CONCLUSION: Sweet eaters do not have less favorable weight outcomes following Lap-Band surgery. Our study confirms the findings of two other major studies. Sweet eating behavior should not be used as a preoperative selection criterion for bariatric surgery.

Adult↗

PubMed2002

Binge eating among gastric bypass patients at long-term follow-up.

BACKGROUND: A better understanding of the relationship of eating behavior and attitudes to weight loss following gastric bypass (GBP) will enable the development of interventions to improve outcome. Thus, the present study sought to characterize the postoperative weight, eating behavior, and attitudes toward body shape and weight in a cross-section of GBP patients. A second objective was to examine the relationship of postoperative binge eating to surgery outcome. METHODS: 99 patients who underwent GBP > 2 and < 7 years before the study start date completed the Eating Disorder Examination-Questionnaire (EDE-Q) and the Three-Factor Eating Questionnaire (TFEQ). Subjects self-reported their current body weight, weight change over the past 3 months, and lowest weight since surgery. RESULTS: BMI remained significantly below the preoperative level, but significant weight regain was reported at long-term follow-up. 46% of participants reported recurrent loss of control over eating (objective or subjective bulimic episodes) on the EDE-Q. These patients constituted a distinctive subgroup with a less favorable outcome, including greater weight regain. CONCLUSION: Self-reported loss of control over eating was related to weight regain after GBP and may be an important target for clinical intervention. The relationship of binge eating and related psychopathology to outcome following GBP warrants further investigation.

Adult↗

PubMed2004

The relationship between healthful eating practices and dental caries in children aged 2-5 years in the United States, 1988-1994.

BACKGROUND: As a result of the introduction of multiple fluoride vehicles and other preventive agents, caries prevalence rates in young children have been declining over the past two decades in the United States. However, changing dietary patterns in young children may offset some of the oral health benefits of fluoridation. The objective of this study was to examine the relationship between caries in primary teeth and healthful eating practices in young children. METHODS: The authors used data from the third National Health and Nutrition Examination Survey to investigate the relationship between healthful eating practices (such as breast-feeding, eating breakfast and consuming five servings of fruits and vegetables a day) and dental caries (untreated tooth decay and overall caries experience) in the primary dentition among children aged 2 through 5 years. RESULTS: The odds of experiencing caries in primary teeth were significantly greater in nonpoor children who did not eat breakfast daily or ate fewer than five servings of fruit and vegetables per day (odds ratio, or OR = 3.77; 95 percent confidence interval, or CI, 1.80 to 7.89 and OR = 3.21; 95 percent CI, 1.74 to 5.95, respectively). No association was found between breast-feeding and caries in primary teeth. CONCLUSION: Young children with poor eating habits are more likely to experience caries. Overall, the findings support the notion that dental health education should encourage parents, primary caregivers and policy-makers to promote healthful eating practices, such as eating breakfast daily, for young children. PRACTICE IMPLICATIONS: Dental professionals are well-positioned to inform parents and caregivers regarding age-appropriate healthful eating practices for young children entrusted in their care.

Age Factors↗

PubMed2005

Relationship between binge-eating episodes and self-perception of body weight in a nonclinical sample of five Brazilian cities.

OBJECTIVE: To investigate the relationship between binge-eating episodes and a perception that body weight is above the ideal in a sample of customers interviewed at shopping malls in five Brazilian cities. METHODS: In 1999, data were collected over the course of one week (Monday-Friday only) at the largest shopping malls in the cities of Porto Alegre, Salvador, Fortaleza, Goiânia and Curitiba (two malls per city). A total of 2855 participants (917 men and 1938 women) were interviewed. Weight and height measurements were standardized. Binge-eating episodes were identified using a questionnaire including the following questions based on DSM-IV diagnostic criteria: "Have you ever eaten, in a period of two hours or less, an amount of food greater than that most people would eat?" and "If the answer was "yes", did you, during these episodes, feel unable to stop eating or to control how much you were eating?". RESULTS: The prevalence of binge-eating episodes was higher among overweight subjects (15.6%) compared with normal-weight subjects (9.9%) (p = 0.0001) and, among subjects who perceived their body weight to be above the ideal (men: 13.9%; women: 15.1%) compared with those who perceived their body weight to be ideal or below the ideal (men: 8%; women: 7%) (p < 0.0001). In the multivariate analysis adjusted for body mass index and demographic variables, binge-eating episodes were correlated with the perception that body weight is above the ideal only among women (OR: 1.8; 95% CI: 1.2-2.5). CONCLUSIONS: These findings suggest that the perception that body weight is above the ideal, regardless of overweight status, is associated with binge-eating episodes in women.

Adolescent↗

PubMed2000

Association between changes in eating and drinking behaviors and respiratory tract disease in newly arrived calves at a feedlot.

OBJECTIVE: To investigate eating and drinking behaviors and their association with bovine respiratory disease complex (BRDC) and to evaluate methods of diagnosing BRDC. ANIMALS: 170 newly arrived calves at a feedlot. PROCEDURE: Eating and drinking behaviors of calves were recorded at a feedlot. Calves with clinical signs of BRDC were removed from their pen and classified retrospectively as sick or not sick on the basis of results of physical and hematologic examinations. Pulmonary lesions of all calves were assessed at slaughter. RESULTS: Calves that were sick had significantly greater frequency and duration of drinking 4 to 5 days after arrival than calves that were not sick. Sick calves had significantly lower frequency and duration of eating and drinking 11 to 27 days after arrival but had significantly greater frequency of eating 28 to 57 days after arrival than calves that were not sick. Calves at slaughter that had a higher percentage of lung tissue with pneumonic lesions had significantly lower frequency and duration of eating 11 to 27 days after arrival but had significantly higher frequency and duration of eating 28 to 57 days after arrival. Agreement for calves being sick and having severe pulmonary lesions at slaughter was adequate. Agreement for calves being removed and having pulmonary lesions at slaughter was low. CONCLUSIONS AND CLINICAL RELEVANCE: Eating and drinking behaviors were associated with signs of BRDC, but there was not an obvious predictive association between signs of BRDC in calves and eating and drinking behaviors. Fair to poor agreement was observed between antemortem and postmortem disease classification.

Animal Husbandry↗

PubMed1994

Signs of subclinical eating disorders in teenage girls.

OBJECTIVE: To study possible indicators for subclinical eating disorders among teenage girls. DESIGN: A descriptive cross-sectional study based on two anonymous self-report questionnaires. SETTING: Girls aged 15 to 19 years in secondary high school in Bergen, Norway. SUBJECTS: 100 girls, mean age 16.6 years, were included. One girl fulfilled DSM-III-R criteria for bulimia nervosa, and was therefore excluded from analysis. Ten girls fulfilled criteria for subclinical eating disorders. MAIN OUTCOME MEASURES: The Eating Disorder Examination Questionnaire and a 48-item questionnaire designed for the study were used. Attitudes towards own body size/weight, food habits, and somatic symptoms were studied. RESULTS: Girls with subclinical eating disorders experienced their own body as fatter and were more unhappy with their weight than girls without eating problems. They more often skipped breakfast or lunch, reported more dyspeptic problems and regurgitation, and had a larger weight fluctuation than girls without eating problems. CONCLUSION: Questions about main meals may serve as neutral opening questions for the general practitioner when case finding in eating disorders. Obviously unrealistic feelings about body size/weight indicate the need to enquire more closely about symptoms of eating disorders.

Adolescent↗

PubMed1992

T cell mapping of one epitope from thyroglobulin inducing experimental autoimmune thyroiditis (EAT).

These data collect the advance made in the last few years in our laboratory in defining one epitope from the thyroglobulin (Tg) molecule (660 KDa) inducing Experimental Autoimmune thyroiditis (EAT) in CBA/J mice. We achieved the characterization of one EAT-inducer Tg peptide by combining "in vitro" biochemical and immunological approaches and "in vivo" studies. Since T cells recognize degraded forms of the antigen and since endogenous antigens preferentially activate class I-restricted T cells, we hypothesized that one cytotoxic T cell hybridoma, named HTC2, which prevents further EAT induction in mice injected with Tg would be specific for one EAT inducer peptide. In order to identify one Tg epitope inducing EAT, enzymatic treatment of the protein by trypsin, HPLC purification and sequence analysis were performed. Simultaneously, tryptic digests were used to pulse CBA/J macrophages and tested for their ability to be recognized by HTC2 cells. Lastly, when digests were recognized by HTC2 cells their capacity to induce EAT in CBA/J mice was evaluated. To further assess the pathogenicity of the sequenced Tg peptide, one synthetic peptide was made and its capacity to induce EAT verified. By this procedure we identified for the first time one 40 amino-acid peptide from human thyroglobulin inducing EAT in CBA/J mice.

Amino Acid Sequence↗

PubMed1984

Effect of artificial photoperiod on eating behavior and other behavioral observations of dairy cows.

Twenty-eight cows were assigned randomly to a daily photoperiod of 18 h light and 6 h darkness or to continuous light and were observed 1 day each month from December 1981 to February 1982. Lighting regimen did not affect eating behavior or milk production. Overall means of total eating time, number of eating bouts, and average time eating per bout on the 3 observation days were 270 to 280 min, 10 to 12 times, and 24 to 27 min. Eating behavior and milk production were not significantly correlated. Eating patterns were similar in both groups and across observation days. Peaks of eating activity occurred before sunset, bracketing the evening milking and after the offering of fresh feed in the morning. Approximately 80% of total eating activity occurred between 0900 and 2100 h in both groups. Cows had a clear preference for entry into the right or left side of the milking parlor, and entry order was repeatable. Milking order and milk production were not correlated. In one group, location of free stalls did not influence utilization; but in the other group, centrally located stalls were utilized more than stalls at either end of the alley. About 40% of cows had individual free stall preferences.

Animals↗

PubMed2002

An open-label trial of sibutramine in obese patients with binge-eating disorder.

BACKGROUND: Binge-eating disorder was recently included in Appendix B of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Binge-eating disorder is a common diagnosis among patients who seek treatment for obesity. There are scant data about the efficacy of the novel antiobesity agents for binge-eating disorder. The objective of this article is to present data from an open-label study of the efficacy and tolerability of sibutramine in a group of obese binge eaters. METHOD: Ten obese patients with DSM-IV binge-eating disorder and no medical comorbidity were consecutively selected from individuals seeking treatment for obesity in our clinic. Treatment with sibutramine, 15 mg/day, was administered for 12 weeks. The number of days with binge episodes per week, the number of binge episodes per week, the Binge Eating Scale (BES), the Beck Depression Inventory, and body weight evaluation were employed for outcome assessment. RESULTS: Seven patients completed the trial. They showed a complete resolution of binge-eating disorder with no binge-eating episodes at the end of the treatment. The mean +/- SD number of days with binge episodes per week changed significantly from 5.2 +/- 1.8 at baseline to 0.8 +/- 1.9 at the end of the study (p < .001), and the mean BES score fell from 31.2 +/- 6.2 to 15.2 +/- 8.2. There was a reduction of body weight (mean = 4.0 kg [8.9 lb]) from baseline to the end of the study. No serious adverse effects were observed. CONCLUSION: Sibutramine might be an effective and well-tolerated agent in the treatment of binge-eating disorder in obese patients.

Adult↗

PubMed1994

Use of substitute food textures for standard eating assessment in children with cerebral palsy and children without disabilities.

OBJECTIVE: Eating assessment is the first step toward amelioration of eating problems in children. A quantitative evaluation tool with three standard textures of food has been developed to determine the severity of an eating problem. However, children occasionally refuse some of the standard textures. Much time and effort could be saved if substitute textures could be used for testing. The purpose of this study was to examine the feasibility of using substitute food textures. METHOD: Twenty children (10 without disabilities, 10 with cerebral palsy and eating impairments) with a mean age of 8.2 years (SD = 4.1) years were tested with three standard and three substitute textures of food (solid viscous, puree. Eating time (in seconds) and chewing cycles were compared between standard and substitute textures as well as between children without disabilities and children with eating impairments. RESULTS: Substitutes for pureed and viscous, but not solid textures could be used for children without disabilities; in children with eating impairments, substitutes for viscous and solid, but not pureed textures could be used. CONCLUSION: Children with eating impairments may be more sensitive than children without disabilities to small changes in food consistencies or other characteristics of the food. Thus, in standardized testing, food textures should not be arbitrarily interchanged.

Adolescent↗

PubMed2000

Mutations of the caenorhabditis elegans brain-specific inorganic phosphate transporter eat-4 affect habituation of the tap-withdrawal response without affecting the response itself.

The studies reported here were designed to investigate the role of the mutation eat-4 in the response to tap and in habituation in the nematode Caenorhabditis elegans. In C. elegans eat-4 has been found to affect a number of glutamatergic pathways. It has been hypothesized to positively regulate glutaminase activity and therefore glutamatergic neurotransmission. In the eat-4(ky5) loss-of-function worms, there is presumably insufficient glutamate available for sustained transmission. In the experiments reported here eat-4 worms showed no differences from wild-type in the magnitude of response to a single tap, indicating that the neural circuit underlying the response was intact and functional in the mutant worms. However, when eat-4 worms were given repeated taps the resulting habituation was different from that seen in wild-type worms: eat-4 worms habituate more rapidly and recover more slowly than wild-type worms at all interstimulus intervals tested. In addition, eat-4 worms do not show dishabituation. The same transgene rescues pharyngeal activity defects and both the habituation and dishabituation deficits seen in the eat-4 worms. Our results suggest that neurotransmitter regulation plays a role in habituation and may play a role in dishabituation.

Animals↗

PubMedDate not supplied

[High-risk eating behavior in Mexican adolescents. Data on the student population in the Federal District].

Data of the Drug and Alcohol Prevalence in Student Population of Mexico City Survey 1997 were used to achieve knowledge about the presence of risk eating behaviors, characteristic of eating disorders in the student population of Mexico city (N = 10,173). The sample was conformed by boys (47.9%) and girls (52.1%), with a mean age of 14.5 years (SD = 1.8). The identification of the differences between boys and girls, and age groups in two occurrence categories of risk eating behavior (ever and two or more times per week) were among the main objectives. An eleven items scale with three answering options about eating behavior during the last three months was used. The BMI-P distributed normally, with greater percentage of overweight, than underweight in both sexes. A greater percentage of risk eating behaviors were found among girls, excluding hard exercising and binge eating, as well as similar percentages of laxative and enema use in both sexes. The analysis held by age groups for risk eating behaviors showed significant differences in binge eating, self induced vomiting, pills and enemas use among boys, while girls showed differences in almost all of these practices, being the group of 18 and 19 years where the greater percentages were found.

Adolescent↗

PubMed2001

[Poisoning from eating horseshoe crab and its prevention and treatment].

During the past three years on investigating and studying the poisoning of eating Horseshoe crab, it has been discovered that the major cause of the poisoning on eating Horseshoe crab in south region along the seacoast of China was taking tetrodotoxin from Carcinoscorpius rotundicauda by mistake; the symptoms of some others from eating Horseshoe crab were the result of allergic reactions from eating Tachypleus tridentatuscause, similar to the reactions from eating shrimp or crab, and which could be cured with chlorpheniramine. The effective prevention measures are not eating Horseshoe crab, especially the young ones. The size of young Carcinoscorpius rotundicauda is similar to the size of the nonpoisonous Tachypleus tridentatuscause. It is very easy to be confused and easy to eat by mistake. The treatment of the poisoning from eating Horseshoe crab is similar to the treatment of tetrodotoxin by removing the toxins from body.

Animals↗