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PubMed2002

Risk factors for binge eating onset in adolescent girls: a 2-year prospective investigation.

Because little is known about the predictors of binge eating (a risk factor for obesity), a set of putative risk factors for binge eating was investigated in a longitudinal study of adolescent girls. Results verified that binge eating predicted obesity onset. Elevated dieting, pressure to be thin, modeling of eating disturbances, appearance overvaluation, body dissatisfaction, depressive symptoms, emotional eating, body mass, and low self-esteem and social support predicted binge eating onset with 92% accuracy. Classification tree analysis revealed an interaction between appearance overvaluation, body mass, dieting, and depressive symptoms, suggesting qualitatively different pathways to binge eating and identifying subgroups at extreme risk for this outcome. Results support the assertion that these psychosocial and biological factors increase risk for binge eating.

Adolescent↗

PubMed2001

[Morbid obesity in women - eating style and quality of life].

Morbid obesity has been widely studied due to its high incidence and its bad consequences to health. Studies about obesity have been emphasized some important aspects such as eating styles and quality of life. This study aim to investigate the eating styles and the quality of life of women with morbid obesity, patients in treatment at the Ambulatory of Eating Disorders, University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo. Sixty women were assessed, 30 obese (Body Mass Index--BMI > or = 40 kg/m2) and 30 nonobese (BMI 20 to 25 kg/m2). A semi-structured interview, the Dutch Eating Behaviour Questionnaire and the Short-form Health Survey: Medical Outcomes Study were used for the assessment, after translate to portuguese and adapted. The data were rated and quantified and the groups were statistically analyzed through the Tests of Mann-Whitney. The groups differed significantly as for restrained (p < or = 0.001) and emotional eating (p < or = 0.01), and did not differ as for external eating. The groups also differed in quality of life, concerning physical and social limitations (p < or = 0.001), the presence of emotional indicators (p < or = 0.001) and general health condition (p < or = 0.001). Findings suggest that eating styles contribute to explain the difficult of eating control--but are not only factor in the obesity characterization. Moreover, morbidly obese women presented a quality of life more compromised and have an adequate perception of their physical, social and emotional limitations. That might favor a therapeutic approach to them.

Adult↗

PubMed2003

Bulimia nervosa and binge-eating disorder in adolescents.

Bulimia nervosa (BN) and binge-eating disorder (BED) are separate entities with the common denominator of binge eating. In this chapter, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for BN are reviewed, including both recurrent episodes of binge eating and inappropriate compensatory behaviors to prevent weight gain in one whose self-evaluation is unduly influenced by body weight and shape. Two percent of adolescent females and 0.3% of adolescent males fulfill criteria for BN. Risk factors, medical complications of binge eating (vomiting, use of ipecac, diet pills, diuretics, and laxatives), physical and laboratory findings, and treatment options and outcome are discussed. BED is seen in 1-2% of adolescents. The DSM-IV lists BED under Eating Disorder Not Otherwise Specified. DSM-IV research criteria for BED is reviewed, including binge eating, distress over binge eating, and absence of regular extreme compensatory behaviors. The mean age of onset is 17.2 years. Up to 30% of obese patients have BED. Risk factors are discussed. Because most patients with BED are obese, medical evaluation is similar to that for obesity. Treatment goals must be geared not only toward decreased binge eating but toward weight loss. Outcome is discussed.

Adolescent↗

PubMed1989

Energy expenditure and the abnormal eating pattern of a bulimic: a case report.

Bulimia nervosa has been characterized by binge eating, which is often followed by either vomiting or laxative use. However, some bulimic individuals restrict caloric intake rather than purge as a means of controlling their weight. Treatment may include psychiatric evaluation, drug therapy, and nutrition counseling. This study evaluated the eating pattern of a bulimic woman from food records made before and while she was receiving nutrition counseling at an eating disorders clinic. Energy expenditure was also determined and examined in relation to patterns of eating behavior. The Harris-Benedict equation was used to estimate basal energy expenditure (BEE). Actual measured energy expenditure (MEE) was determined by indirect calorimetry. On initial assessment, this woman was eating 600 to 3,800 kcal/day, reflecting the range from a semi-fast to a binge day. At this time, her BEE was significantly higher than her MEE. Following modification of her eating pattern to three meals a day, providing approximately 1,200 kcal, there was a 50% increase in her MEE, which closely approximated her BEE. Modification of eating pattern appeared to be associated with a normalization of energy expenditure in this woman; however, each case must be considered individually. These results imply that certain eating patterns in bulimic individuals cause a decrease in energy expenditure that may resemble starvation.

Adult↗

PubMed1988

Eating disorders in a nonclinical adolescent population: implications for treatment.

The present study investigates the prevalence of adolescent eating disorders across gender, cultural groupings, and socioeconomic status. The Eating Attitudes Test, the Binge-Eating Questionnaire, and a demographic questionnaire were administered to students at two high schools. The results indicate a high rate of eating disorders in a nonclinical adolescent population. The rates for binge eating are comparable to those found in studies of college students--found at a younger age. With regard to SES, cross-cultural and gender findings, it is clear that eating disorders cross socioeconomic class and ethnic groups, and have a higher rate of occurrence in males than previously reported. Given such high rates of eating problems in a nonclinical population, the issue of prevention and early detection must be addressed. Additionally, more specific information on male eating disorders is needed.

Adolescent↗

PubMed1995

Prevalence of eating disorders and minor psychiatric morbidity in central Europe before the political changes in 1989: a cross-cultural study.

The prevalence of culture-bound syndromes such as eating disorders in the countries of Central and Eastern Europe is unclear and comparative epidemiological studies are lacking. Before the political changes in 1989 we therefore investigated eating disorders, eating attitudes and psychological health in two Eastern European countries and in one Western democracy. A total of 1225 female and male medical students in Hungary, the German Democratic Republic (GDR) and Austria were surveyed. The instruments included the Eating Disorder Inventory and the GHQ. The prevalence of eating disorders was calculated on the basis of simulated DSM-III-R diagnosis. In females, bulimia nervosa prevalence rates of 0.6% (95% CI 0.02, 3.46), 1% (0.2, 2.95) and 0% (0, 2.07) were calculated for Austria, Hungary and the GDR, respectively. For subclinical bulimia nervosa, the rate for Hungary (3.8%; 1.95, 6.72) was twice as high as for Austria (1.9%; 0.39, 5.5) and the GDR (1.7%; 0.36, 4.88). Hungarian subjects indicated more psychiatric 'caseness' than their GDR or Austrian counterparts. We conclude that eating disorders represented at least as common a problem in Eastern as Western Europe before the changes in political organization. This may be due to an identification process with Western values. A further increase of eating disorders in these countries induced by the recent changes may be possible.

Adult↗

PubMed2005

Association between the insulin-like growth factor 2 gene (IGF2) and scores on the Eating Attitudes Test in nonclinical subjects: a family-based study.

OBJECTIVE: An interesting candidate gene for eating disorders is the gene for insulin-like growth factor 2 (IGF2). Located on chromosome 11p15.5, IGF2 is a member of the insulin family of polypeptide growth factors that is involved in development and growth. Consistent with its profile of metabolic actions, an association has been reported between a single nucleotide polymorphism (SNP) in the 3' untranslated region of the IGF2 gene (ApaI) and body mass index. This investigation extended these studies and investigated the psychological and behavioral implications of this hormone's impact on metabolism and body composition. METHOD: The authors tested nonclinical subjects from 376 families for three IGF2 SNPs and for eating disorders, as reflected in scores on the 26-item Eating Attitudes Test, a self-report questionnaire widely used as a screening instrument. RESULTS: A highly significant association was observed between the IGF2 ApaI G allele and scores on the Eating Attitudes Test overall and each of its subscales (bulimia, dieting, and oral control). Additionally, a significant association was observed between this polymorphism and body mass index. CONCLUSIONS: The current finding that the IGF2 ApaI G polymorphism, which predisposes to weight gain, may also contribute to the pathology of eating disorders is intriguing. Neurotransmitter modulation of appetitive behavior is the focus of most hypotheses regarding the etiology of severe eating disorders. The current results to some measure challenge this view, and inborn metabolic tendencies to weight gain in some women may trigger constant dieting, which in predisposed individuals eventually leads to severe eating disorders.

Adolescent↗

PubMed2000

Dieting and the development of eating disorders in overweight and obese adults.

We reviewed articles evaluating the relations among dieting, weight loss treatment, weight cycling, eating disorders, and psychological functioning in overweight and obese adults. Moderate caloric (energy) restriction, in combination with behavioral weight loss treatment, does not seem to cause clinically significant binge eating in overweight adults without preexisting binge eating problems and might ameliorate binge eating, at least in the short term, in those reporting recurrent binge eating before treatment. Most studies of behavioral weight loss interventions report improvements in psychological status during weight loss. However, these improvements might return to baseline with weight regain. Weight cycling does not seem to be associated with clinically significant psychopathologic conditions, although results of cross-sectional studies show an association between weight cycling and binge eating, as well as poorer perceived health status. "Nondieting" approaches seem to lead to improvements in mood and self-esteem; however, weight loss is generally minimal. Concerns that dieting induces eating disorders or other psychological dysfunction in overweight and obese adults are generally not supported by empirical studies. Such concerns should not preclude attempts to reduce caloric intake and increase physical activity to achieve modest weight loss or prevent additional weight gain.

Adult↗

PubMed1998

Disordered eating among adolescents with chronic illness and disability: the role of family and other social factors.

OBJECTIVES: To compare prevalence rates of weight-control behaviors among adolescents with and without chronic illness and to explore the role of familial and other social factors on associations between disordered eating and chronic illness. DESIGN AND SETTING: Survey conducted in public schools in Connecticut. PARTICIPANTS: A representative statewide population-based sample of 9343 7th-, 9th-, and 11th-grade public school students, of whom 1021 reported a chronic illness. MAIN OUTCOME MEASURES: Disordered eating (vomiting, diet pills, and laxatives), dieting, and exercise for weight control; chronic illness status; family structure, family communication, parental caring, parental monitoring, parental expectations, peer support, and sexual and physical abuse. RESULTS: Adolescents with chronic illness were at greater risk for disordered eating than youth without chronic illness, after controlling for sociodemographic variables (girls: odds ratio, 1.59 [95% confidence interval, 1.19-2.14]; boys: odds ratio, 2.22 [95% confidence interval, 1.49-3.32]). Adolescents with chronic illness were less likely to come from 2-parent families; reported lower levels of family communication, parental caring, and parental expectations; and reported more sexual and physical abuse than youth without chronic illness. Male adolescents with chronic illness were more likely to report low peer support and low parental monitoring. Most of these familial-social factors were also associated with an increased prevalence of disordered eating. After familial-social factors were controlled for, however, associations between disordered eating and chronic illness remained statistically significant. CONCLUSIONS: Adolescents with chronic illness are at greater risk for disordered eating behaviors than youth without chronic illness. Factors other than the familial-social factors assessed in this study may be contributing to this increased risk. In the clinical setting, youth with chronic illness need to be screened for disordered eating and familial and other social concerns.

Adolescent↗

PubMed1997

Subjective and physiological cephalic phase responses to food in obese binge-eating women.

OBJECTIVE: The subjective and physiological cephalic phase reactivity to food was investigated in obese binge-eating women. METHOD: Eleven obese binge-eating women and 10 obese nonbinge-eating women participated in a cephalic phase response test consisting of baseline, anticipation, food exposure, and free eating periods. Serum insulin, free fatty acids, and plasma glucose concentrations as well as salivation, feeling of hunger, and desire to eat were repeatedly measured during the test. RESULTS: During the food exposure, the binge eaters reported more desire to eat than did the nonbinge eaters. No differences were found between the groups in the physiological cephalic phase responses except for the lower salivation in the binge eaters during the food exposure. The amount of food eaten after the food exposure was similar in both groups. DISCUSSION: Binge-eating women are characterized by stronger subjective but not stronger physiological cephalic phase reactivity to food.

Adult↗

PubMed1997

Comparison of men and women with binge eating disorder.

OBJECTIVE: This study examined gender differences in individuals with binge eating disorder (BED) on eating-related psychopathology and general psychological functioning. METHOD: Subjects were age-matched men (n = 21) and women (n = 21) with BED who were administered the Eating Disorders Examination (EDE), the Structured Clinical Interview for DSM-III-R (SCID) and SCID II, and who completed the Emotional Eating Scale (EES) and other questionnaires regarding psychological functioning. RESULTS: Men and women did not differ on measures of eating disturbance, shape and weight concerns, interpersonal problems, or self-esteem, but more men than women met criteria for at least one Axis I diagnosis and had a lifetime diagnosis of substance dependence. Women were more likely to report eating in response to negative emotions, particularly anxiety, anger and frustration, and depression. DISCUSSION: Results from our study suggest that while men and women presenting for treatment for BED are very similar, males may have more Axis I psychiatric disturbance and less emotional eating than their female counterparts. These findings are discussed in terms of the role of gender in BED and possible treatment implications are explored.

Adult↗

PubMed1997

Effects of coping style and negative body image on eating disturbance.

OBJECTIVE: Relationships among coping strategies, negative body image, and eating disturbance were studied. METHOD: Subjects were 128 college women; measures included the Eating Attitudes Test (EAT-26), the Coping Inventory for Stressful Situations (CISS), and three indices of negative body image. RESULTS: Higher use of both emotion-oriented coping and avoidance-oriented coping via distraction was associated with higher EAT scores; higher use of emotion-oriented coping also was associated with more negative body image. Findings agree with data associating these coping styles with other measures of psychological distress and psychopathology. Task-oriented coping also was high, but unrelated to negative body image or eating disturbance. Hierarchical regression analysis yielded a significant interaction between emotion-oriented coping and negative body image: The higher the use of emotion-oriented coping, the less the level of negative body image appeared to affect EAT score. DISCUSSION: Both the main effect for coping and the interaction suggest that high use of emotion-oriented coping should be considered a risk factor for eating disturbance.

Adaptation, Psychological↗

PubMed1998

Disordered eating in adolescent males from a school-based sample.

OBJECTIVE: The authors sought to describe a sample of adolescent males who reported disordered eating, to explore whether males with disordered eating are overweight or obese, and to determine if patterns displayed by females would be replicated with a male sample. METHOD: Three school-based adolescent samples were selected. (1) 27 males reporting disordered eating (2) 27 physically matched controls, and (3) 27 randomly selected controls. RESULTS: Findings indicated that boys reporting disordered eating expressed greater body dissatisfaction, depression, restraint, and poorer interoceptive awareness compared to matched and randomly selected controls. Negative Emotionality and poor Interoceptive Awareness scores showed the strongest associations with eating pathology. Body mass index and Negative Emotionality scores showed the strongest relationships to restrained eating. DISCUSSION: Previous results for female adolescents were replicated, suggesting that findings for females can be generalized to males. Disordered eating appears to exist in the absence of significant weight problems in adolescent males.

Adolescent↗

PubMed1998

The epidemiology of eating disorder behaviors: an Australian community-based survey.

OBJECTIVE: The study aims were to evaluate the prevalence and distribution of respective eating disorder behaviors (DSM-IV criteria) in a representative community-based sample. METHOD: Data were obtained from 3,001 interviews of a randomly selected sample of 4,200 individuals' (age > 15 years) households in South Australia. RESULTS: Ninety-six (3.2%) of respondents had regular current episodes of binge eating, 48 (1.6%) regularly fasted or used strict dieting, 24 (0.8%) purged. An estimated 8 (0.3%) had bulimia nervosa and 30 (1%) had binge eating disorder. Binge eating and dieting were most common in people who were in their early to mid thirties. Dieting and purging, but not regular binge eating, were more common in women than in men. Purging was most common in the 35-44 year age range. The only behavior significantly associated with (increased) weight was binge eating. Unmarried subjects were less likely to diet than married subjects. No significant differences in rates of these behaviors were found for household income. DISCUSSION: Problematic eating disorder behaviors in older women and in men were more common than expected and merit further clinical and research attention.

Adult↗

PubMed1998

Correlates of binge eating in Hispanic, black, and white women.

OBJECTIVE: We sought to compare the severity and correlates of binge eating in White, Black, and Hispanic women. METHOD: Our sample consisted of 351 (55 White, 179 Black, and 117 Hispanic) women who were assessed on three proposed factors associated with binge eating (weight, depression, and ideal body image). RESULTS: Our results showed that binge eating symptoms were more severe in our sample of Hispanic versus Black or White women. Across all ethnic groups, women who binged more were heavier, more depressed, and preferred a slimmer body ideal. Binge eating severity was predicted by weight and depression in Hispanics and by depression in Whites. None of the proposed factors significantly influenced binge eating in Blacks. DISCUSSION: These results show ethnic differences in the correlates of binge eating and highlight the need for further comparative research on aberrant eating patterns.

Adult↗

PubMed1999

Risk factors for the emergence of childhood eating disturbances: a five-year prospective study.

OBJECTIVE: Research suggests that eating problems are often present by preadolescence, yet little is known about the age of emergence of these early eating disturbances or risk factors for these behaviors. Thus, we investigated the timing of onset of disturbed eating during childhood and the predictors of these behaviors. METHOD: These aims were addressed by following a sample of children and their parents (N = 216) for the first 5 years of the children's lives. RESULTS: Data suggested that the risk for emergence of inhibited eating, secretive eating, overeating, and vomiting increased annually through age 5. Maternal body dissatisfaction, internalization of the thin-ideal, dieting, bulimic symptoms, and maternal and paternal body mass prospectively predicted the emergence of childhood eating disturbances. Infant feeding behavior and body mass during the first month of life also predicted the emergence of these behaviors. DISCUSSION: Results suggest that eating disturbances emerge during childhood and may be a function of certain parental and child characteristics.

Adult↗

PubMed1999

Eating disorders in a national sample of hospitalized female and male veterans: detection rates and psychiatric comorbidity.

OBJECTIVE: Using a national sample of hospitalized female and male veterans, this study examined the point prevalence of detected cases of eating disorders and explored psychiatric comorbidity in cases with an eating disorder. METHODS: Prevalence rates were determined by reviewing the discharge diagnoses of 24,041 women and 466,590 men hospitalized in Veteran Affairs medical centers during fiscal year 1996. Comorbidity was examined by individually matching eating disorder cases (N = 161) with patients without an eating disorder, using sex, race, and age as matching variables. RESULTS: On the basis of routine clinical diagnosis, 0.30% of the female veterans and 0.02% of the male veterans were diagnosed with a current ICD-9-CM eating disorder. Women with eating disorders had significantly elevated rates of comorbid substance, mood, anxiety (particularly posttraumatic stress disorder [PTSD]), adjustment, and personality (particularly borderline personality disorder [BPD]) disorders. Men with eating disorders were found to have high rates of comorbid organic mental, schizophrenic/psychotic, substance, and mood disorder. CONCLUSIONS: Our study illustrates the value of administrative data sets for the investigation of uncommon diseases.

Adult↗

PubMed1999

The role of ethnicity and parental bonding in the eating and weight concerns of Asian-American and Caucasian college women.

OBJECTIVES: The purpose of this research was to explore the associations among ethnicity, parental bonding, acculturation, and eating disturbance in Asian-American and Caucasian weight-concerned college women. METHODS: Twenty-five Asian-American and 26 Caucasian weight-concerned women were administered the Eating Disorder Examination interview, the Parental Bonding Instrument, and three subscales of the Eating Disorder Inventory. Asian-American subjects also filled out the Suinn-Lew Asian Self-Identity Acculturation Scale questionnaire. RESULTS: Contrary to hypotheses, weight-concerned Asian-American women reported more dissatisfaction with body shape than did Caucasian women. Moreover, in the Asian-American group, acculturation was not associated with level of eating disturbance. In both groups, perceptions of low maternal caring were associated with higher levels of eating problems. In regression analyses, maternal care emerged as a better predictor of eating disturbance than did ethnicity. DISCUSSION: Results suggest that quality of parent-child relations, particularly the mother-daughter relationship, may be important in the etiology of eating problems, irrespective of ethnicity. Longitudinal investigations will be required to test causal relations.

Acculturation↗