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Food preferences, eating patterns, and physical activity among adolescents: correlates of eating disorders symptoms.

PURPOSE: Food preferences, eating patterns, and physical activity patterns were examined in a cohort of adolescent females and males participating in a longitudinal study of the developmental antecedents of eating disorders. METHODS: All adolescents (n = 1494) in grades seven through ten in an entire school district completed a survey about their dieting behaviors, eating, and exercise patterns. RESULTS: Principal components analysis showed similar factor structures for food preferences and eating patterns among males and females. Gender differences were present in physical activity patterns. Sports participation was correlated with healthy food preference and was a significant predictor of eating disorders symptoms. Junk food preference was marginally inversely related to eating disorders symptoms in females. Preference for other types of foods and reported intake of foods were not related to eating disorders symptoms. The percent of variance in risk score accounted for by dietary intake and physical activity patterns was small. CONCLUSIONS: Psychological and social/environmental variables may explain a larger proportion of the variance in eating disorders risk than the dietary and physical activity variables examined in this study. Implications for understanding the etiology and behavioral expression of eating disorders are discussed.

Adolescent↗

Effects of intensive lifestyle interventions with calorie-carbohydrate-restricted diet versus time-restricted eating on appetite and binge eating in type 2 diabetes: A randomized controlled trial.

The impact of intensive lifestyle interventions on appetite regulation and binge eating in individuals with type 2 diabetes (T2D) remains unclear. This study evaluated the effects of combined lifestyle interventions on appetite responses and binge eating in overweight or obese adults with T2D. In a randomized trial, 120 participants with T2D were allocated to three groups (n&#xa0;=&#xa0;40 each): (1) Calorie-carbohydrate restriction (CCR), (2) Time-restricted eating with CCR (TRE&#xa0;+&#xa0;CCR), or (3) Control. Intervention groups received structured exercise and behavioral education based on the Information-Motivation-Behavioral Skills model. Appetite perceptions (hunger, satiety, desire to eat, and prospective food consumption) and binge eating (Binge Eating Scale; BES and objective binge episodes) were evaluated at baseline, week 12, and week 24 using linear mixed models. Both CCR and TRE&#xa0;+&#xa0;CCR significantly improved subjective appetite compared with the control group at 12 and 24 weeks (all p&#xa0;<&#xa0;0.01). At 24 weeks, hunger decreased by -24.1&#x202f;mm (95% CI: -35.8, -12.5) in the CCR group and -32.7&#x202f;mm (95% CI: -44.2, -21.3) in the TRE&#xa0;+&#xa0;CCR group. Satiety also increased by 21.7&#x202f;mm (95% CI: 9.46, 33.9) and 29.4&#x202f;mm (95% CI: 17.4, 41.4), respectively. Significant reductions were observed for desire to eat and prospective food consumption. In contrast, changes in BES and objective binge episodes were not significantly different between groups at any time point. No significant differences were detected between the CCR and the TRE&#xa0;+&#xa0;CCR groups. Intensive lifestyle interventions incorporating CCR or TRE&#xa0;+&#xa0;CCR effectively reduced appetite in adults with T2D but did not significantly affect binge eating. Future research should target individuals with higher baseline BES scores to clarify potential benefits for binge eating behavior.

Humans↗

Teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in binge eating disorder.

OBJECTIVE: The primary goal of this study was to examine associations among teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in women with Binge Eating Disorder (BED). RESEARCH METHODS AND PROCEDURES: Subjects were 115 female adults who met DSM-IV criteria for BED. Measurements assessing teasing history (general appearance [GAT] and weight and size [WST] teasing), current eating disorder psychopathology (binge frequency, eating restraint, and concerns regarding eating, shape, and weight), body dissatisfaction, and psychological functioning (depression and self-esteem) were obtained. RESULTS: History of GAT, but not WST, was associated with current weight concerns and body dissatisfaction, whereas both GAT and WST were significantly associated with current psychological functioning. Patients with earlier onset of obesity reported more WST than patients with later onset of obesity, but the groups did not differ significantly in GAT, current eating disorder psychopathology, body dissatisfaction. or psychological functioning. Obese women reported more WST than non-obese women, but no differences in GAT or the other outcome variables were observed. Higher frequency of GAT was associated with greater binge frequency in obese women, and with greater eating restraint in non-obese women. DISCUSSION: Although physical appearance teasing history is not associated with variability in most eating disorder psychopathology, it is associated with related functioning, most notably body dissatisfaction, depression, and self-esteem. Our findings also suggest that the age of onset of obesity and current body mass index status in isolation are not associated with eating psychopathology or associated psychological functioning in adult patients with BED.

Adult↗

Sleep-related eating disorders: polysomnographic correlates of a heterogeneous syndrome distinct from daytime eating disorders.

Over a 5-yr period, 19 adults presented to our sleep disorders center with histories of involuntary, nocturnal, sleep-related eating that usually occurred with other problematic nocturnal behaviors. Mean age (+/- SD) at presentation was 37.4 (+/- 9.1) yr (range 18-54); 73.7% of the patients (n = 14) were female. Mean age of sleep-related eating onset was 24.7 (+/- 12.9) yr (range 5-44). Eating occurred from sleep nightly in 57.9% (n = 11) of patients. Chief complaints included excessive weight gain, concerns about choking while eating or about starting fires from cooking and sleep disruption. Extensive polysomnographic studies, clinical evaluations and treatment outcome data identified three etiologic categories for the sleep-related eating: (a) sleepwalking (SW), 84.2% (n = 16); (b) periodic movements of sleep (PMS), 10.5% (n = 2) and (c) triazolam abuse (0.75 mg hs), 5.3% (n = 1). DSM-III Axis 1 psychiatric disorders (affective, anxiety) were present in 47.4% (n = 9) of the patients, and only two patients had a daytime eating disorder (anorexia nervosa), each in remission for 3-7 yr. Nearly half of all patients fulfilled established criteria for being overweight, based on the body mass index. Onset of sleep-related eating was linked directly to the onset of SW, PMS, triazolam abuse, nicotine abstinence, chronic autoimmune hepatitis, narcolepsy, encephalitis or acute stress. In the SW group, 72.7% (8/11) of patients had nocturnal eating and other SW behavior suppressed by clonazepam (n = 7) and/or bromocriptine (n = 2) treatment. Both patients with PMS likewise responded to treatment with combinations of carbidopa/L-dopa, codeine and clonazepam. Thus, sleep-related eating disorders can generally be controlled with treatment of the underlying sleep disorder.

Adolescent↗

Comorbidity of binge eating disorder and the partial binge eating syndrome with bipolar disorder.

OBJECTIVE: The authors examined the prevalence of binge eating disorder (BED), partial binge eating syndrome, and night binge eating syndrome in subjects with bipolar disorder (BD). METHOD: Sixty-one subjects in whom BD was established using DSM-III-R criteria received a semistructured clinical interview including a detailed description of binge eating behavior and of night binge eating. Frequencies were compared to prevalence estimates in community samples. RESULTS: Eight subjects (13%) met DSM-IV criteria for the diagnosis of BED. An additional 15 subjects (25%) exhibited a partial binge eating syndrome. These two otherwise identical groups of binge eaters were separated only by the DSM-IV frequency criterion. The rates found were higher than rates found in community samples. Ten subjects reported night binge eating in addition to their usual binge eating behavior. This occurred consistently between 2:00 and 4:00 a.m. CONCLUSIONS: Possible underlying mechanisms for the high frequency of binge eating among bipolar subjects are discussed including a model of serotonin-mediated self-modulation of mood. The finding of two groups of binge eaters separated only by the frequency criterion raises questions as to whether the frequency criterion as presently defined in DSM-IV is valid or should be modified.

Adult↗

Age of onset for binge eating: are there different pathways to binge eating?

OBJECTIVE: In examining individuals with binge eating disorder (BED), we aimed to determine whether their binge eating preceded their first diet or their first diet preceded their binge eating, the age of their first diet, the age of their first binge, and the age when they met DSM-IV criteria for BED. Additionally, we aimed to identify psychological factors that may distinguish the two groups. METHODS: Eighty-seven individuals with BED (19 men and 68 women) were administered the Eating Disorders Examination, the Structured Clinical Interview for DSM-III-R, and several other measures of psychological functioning and psychiatric disturbance. RESULTS: Forty-five percent of the subjects reported that dieting preceded their first binge episode (dietfirst) and 55% reported that binge eating preceded their first diet (bingefirst). There were no significant differences in current eating disturbance, body mass index (BMI), or age for these two groups, but they differed on the age of the first episode of binge eating and the age when binging met BED criteria. The group reporting having binged first had a younger age of onset of binge eating and a younger age at which binge eating met diagnostic criteria than the dietfirst group. The bingefirst group also had a history of more psychiatric problems and were more likely to have an Axis II personality disorder. DISCUSSION: Age of onset of the first binge and BED is markedly different depending on whether an individual began dieting or binging first. These findings suggest that there may be important etiological differences between individuals who binge first and those who diet first. Moreover, individuals who binge first may be at greater risk for psychiatric disturbance.

Adolescent↗

Avoidance coping, binge eating, and depression: an examination of the escape theory of binge eating.

The relationship between binge eating, avoidance coping, and depression was investigated with reference to the escape theory of binge eating which predicts binge eaters will exhibit elevated avoidance coping. Undergraduate females were selected into one of three groups: control (nonrestrained/nonbinge eating) (n = 73), restrained (restrained/ nonbinge eating) (n = 61), and binge eating (restrained/binge eating) (n = 15). The groups did not differ on use of avoidance coping. Binge eating scores were significantly correlated with avoidance coping and depression, but hierarchical regression analyses indicated avoidance coping did not significantly add to the prediction of binge eating above the contribution of depression. It is proposed therefore, that it is not appropriate to use findings of elevated avoidance coping in individuals with eating disorder in support of the escape theory.

Adaptation, Psychological↗

Evaluating the effects of eating disorder memoirs on readers' eating attitudes and behaviors.

OBJECTIVE: More than 50 individuals have published eating disorder (ED) memoirs. The current study was the first to test whether memoirs affect readers' eating attitudes and behaviors, and whether they normalize and/or glamorize EDs. METHOD: Fifty female undergraduates read an ED or control memoir. Before and afterward, participants completed the 26-item Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI) Drive for Thinness subscale, a measure of perceived ED symptom prevalence, and an Implicit Association Test (IAT) measuring associations between anorexia and glamour/danger. RESULTS: Participants in the ED condition did not demonstrate significant changes in the EAT-26, the EDI Drive for Thinness subscale, perceived symptom prevalence, or IAT associations compared with controls. Before reading, the EAT-26 and EDI Drive for Thinness subscale correlated positively with perceived symptom prevalence and strength of the IAT association between anorexia and glamour. CONCLUSION: ED memoirs appear to have little effect on undergraduates' eating attitudes and behaviors. Future research should investigate whether memoirs affect individuals with preexisting eating pathology, who may normalize and glamorize ED symptoms.

Adolescent↗

Self-recognition of disordered eating among women with bulimic-type eating disorders: A community-based study.

OBJECTIVE: Self-recognition of eating-disordered behavior was examined in a community sample of young adult women (n = 158) with bulimic eating disorders. METHOD: A vignette was presented describing a fictional person meeting diagnostic criteria for bulimia nervosa. Participants were asked whether they might currently have a problem such as the one described. Scores on measures of eating disorder psychopathology, functional impairment and general psychological distress were compared between participants who recognized a problem with their eating and those who did not. RESULTS: Participants who recognized a problem with their eating (n = 86, 51.9%) had higher levels of eating disorder psychopathology and general psychological distress, were more likely to engage in self-induced vomiting, and tended to be heavier, than those who did not (n = 72, 48.1%). In addition, participants who recognized a problem were more likely to have received treatment for an eating or weight problem. In multivariate analysis, the occurrence of self-induced vomiting and higher body weight were the only variables significantly associated with recognition. CONCLUSION: Poor recognition of eating-disordered behavior may be conducive to low or inappropriate treatment seeking among individuals with bulimic- type eating disorders. The perception that only disorders involving self-induced vomiting are pathological may need to be addressed in prevention programs.

Adult↗

Preference and motivation of laying hens to eat under different illuminances and the effect of illuminance on eating behaviour.

1. In experiment 1, 10 laying hens were given the choice to eat food pellets from any of 4 food bowls illuminated by overhead, incandescent luminaires at <1, 6, 20 or 200 lux. During a trial hens were allowed to eat for 5 min. After each minute had elapsed (from the start of eating) the light sources were extinguished and the illuminances re-assigned to the food bowls in a random manner. Each hen received two trials, one where the food was freely available and another where it was hidden in a sand and gravel mix. 2. The hens chose to eat for most time in the brightest (200 lux) and least in the dimmest (<1 lux) environments for both free and hidden food (free: 5.9, 10.5, 10.4, 15.7s for increasing illuminance; Hidden: 5.5, 9.8, 9.1 and 15.7s. 3. In experiment 2, 9 hens were trained to peck at either an illuminated or unilluminated panel to access a food reward behind a guillotine door for 3 s. Five hens were trained to peck the illuminated panel to access food brightly lit (200 lux) or the unilluminated panel to access food dimly lit (<1 lux); 4 hens were trained vice versa. The flock was then divided into three groups of three, and three treatments imposed on each group in a Latin-square arrangement. In treatment 1, one peck at either panel allowed access to the chosen light environment (F1:F1). In treatment 2, 5 pecks were required to access food brightly lit on a variable ratio, but only one to access food dimly lit (ratio V5:F1). In treatment 3, the variable ratio was increased to V10:F1 to access food in the light. 4. Over 40 trials for each hen, the mean number of attempts to eat food in the light (where the panel which allowed access to food brightly lit was pecked at least once) was 34.5 for F1:F1, 12.1 for V5:F1 and 8.5 for V10:F1. The mean number of food rewards taken in bright light was 34.5, 3.1 and 1.8, respectively. For both variables, the difference between F1:F1 and V5:F1 was significant but not between V5:F1 and V10:F1. By interpolation of the 'attempts' data, it was estimated that hens would work 2.3 times harder to gain access to food brightly lit than for food dimly lit. 5. In experiment 3, the influence of the same illuminances applied over a food bowl as in experiment 1 (<1, 6, 20 or 200 lux) on the number of pecks/min, food consumed/min, food consumed/peck and the force of pecks was examined. 6. The amount of food consumed was lowest in the dimmest environment (3.1 vs 7.5, 7.4 and 7.1 g/ min for increasing illuminance, respectively); as was the number of pecks (35.6 vs. 125.0, 123.1, and 125.4 pecks/min respectively for increasing illuminance). The amount consumed per peck did not vary significantly with illuminance. The mean peck force showed a trend to be lowest in the dimmest environment (5.3 vs. 6.6, 7.0 and 6.6 N respectively, for increasing illuminance). 7. Overall, the hens showed a preference and appeared motivated to eat in bright as opposed to dim light. The hens were unwilling to eat at low illuminances although the 'efficiency' of eating (g/peck) was not impaired significantly. These data may have implications for novel lighting systems and those where hens are required to eat in the dark or in very dim light.

Animal Feed↗

Emotional eating and eating disorder psychopathology.

The study examined to what extent emotional eating, restrained eating, and bulimic tendencies are found together in naturally occurring groups, and whether these groups differ in terms of the psychological characteristics relevant to eating disorders. One hundred twenty-seven normal-weight women filled in The Dutch Eating Behavior Questionnaire, The Eating Attitudes Test, The Eating Disorder Inventory, and five measures of psychological well-being. Cluster analysis revealed three dieter subgroups (Normal Dieters, Emotional Dieters, and Bulimic Dieters) and one nondieter group. The results showed that only some restrained eaters were emotional eaters and that only some emotional eaters had bulimic tendencies. In addition, emotional and bulimic dieters differed from nondieters more strikingly in terms of eating disorder psychopathology and low psychological well-being than normal dieters did. The results suggest that emotional eating is not responsible for overeating only but may, in concert with chronic dieting, also relate to the general psychopathology found to underlie eating disorders.

Journal Article↗

Body composition, eating behavior, food-body concerns and eating disorders in adolescent girls.

AIMS: Dieting is a behavioral phenomenon which is becoming more frequent among adolescents and the search for weight loss, through dieting, may result in an unbalanced nutrition both quantitatively and qualitatively. Our study intended to look at the eating habits and behavior on a cohort of adolescent girls to verify the presence of unbalanced diets and the prevalence of eating disorders with particular attention to the partial syndromes (EDNOS). METHODS: A cross-sectional double-stage study was carried out on a group of schoolgirls in the suburbs of Naples. We assessed anthropometrical measures, body composition (skinfolds and bioimpedance analysis), dietary intake by means of 3-day food records and we administered the Eating Disorder Inventory 2 and Psychosocial Factor Risk Questionnaire. A multidisciplinary and double-stage approach had been used to get a better diagnosis of eating disorders in our sample. RESULTS: 156 adolescent girls, 14-18 years old, took part in our study. Height, weight, and BMI were 160.38 cm, 58 kg and 22.6, respectively. Analysis of food intake showed that all the values reported, with the exception of lipids and sodium, were below the recommendations by LARN. We observed a prevalence of 1.28% of bulimia nervosa, 1.28% of binge eating, and 10.25% of eating disorders not otherwise specified. EDI 2 and PRFQ confirmed how important drive for thinness and body dissatisfaction dimensions are when we deal with adolescent girls and with the phenomenon of dieting. The study confirmed the validity of the PRFQ questionnaire to evaluate mass media influence on body perception and eating behavior of adolescents. CONCLUSION: Multidisciplinary and well-designed studies are needed to systematically and accurately study eating habits and behavior of adolescents to tackle more efficiently the increasing spread of eating disorders and obesity.

Adolescent↗

[Family environment in eating disorders: a study of the familiar factors influencing the onset and course of eating disorders].

OBJECTIVE: This study investigated the association of family environment and symptomatic characteristics in eating disorders. METHOD: The subjects studied were 180 eating disorder patients who sought treatment at Tokai University Hospital and whose diagnoses were made using the SCID (Structured Clinical Interview for DSM-III-R) modified for DSM-IV. The subjects consisted of 52 Anorexia Nervosa Restricting Type (AN/R), 40 Anorexia Nervosa Binge-Eating/Purging Type (AN/BP), 57 Bulimia Nervosa Purging Type (BN/P), 17 Bulimia Nervosa Nonpurging Type (BN/NP) and 14 Binge-Eating Disorder (BED). All subjects were given the Family Adaptability & Cohesion Evaluation Scales III (FACES-III). Seventy eight female college students were administered the FACES-III, as normal controls. RESULTS: On the cohesion (CO) dimensions of FACES-III, most AN/R perceived their families as significantly enmeshed (high CO), whereas most BN and BED perceived their families as disengaged (low CO). The families of AN/BP rated lower CO than AN/R, and higher CO than BN. On the adaptability dimension of FACES-III, most AN/BP and BED perceived their families as rigid, and most BN/P perceived their families either rigid or chaotic. DISCUSSION: 1) The family environment of eating disorder patients exist, on a continuum of cohesion, from AN/R (enmeshed), through AN/BP (intermediate cohesion) and BN (disengaged), to BED (most disengaged). It's suggested that there might be an association of enmeshed family environment and severity of restrict-eating. In addition, the disengaged family environment might have an association with the onset of binge-eating. 2) It's also suggested that the two extremes on the adaptability dimension, rigid and chaotic, were the characteristic features of the family environment, which might precipitate and maintain binge-eating and purging symptoms. 3) The two hypotheses were proposed with regard to the familiar contribution on the outcome of AN/R. (a) AN/R, whose family environment are enmeshed, would not develop bulimic symptoms in the future. (b) AN/R, whose family environment are disengaged, particularly with rigid or chaotic atmosphere, have high risks of developing bulimia later. 4) The author discussed that dividing AN/BP into the two categories: binge subtype and non-binge subtype, should be recommended in the future diagnostic classification of the eating disorders, on the basis of analyzing both groups' family environments. 5) Comparing the family environment of the Japanese BED and the western BED suggested that the Japanese BED might be more severe in psychopathology. The author discussed the comorbidity of BED and the Borderline Personality Disorder, as well as the social influence on the clinical features of BED.

Adult↗

Physiologic Screening Test for Eating Disorders/Disordered Eating Among Female Collegiate Athletes.

OBJECTIVE: To develop and evaluate a physiologic screening test specifically designed for collegiate female athletes engaged in athletic competition or highly athletic performances in order to detect eating disorders/disordered eating. No such physiologically based test currently exists. METHODS: Subjects included 148 (84.5%) of 175 volunteer, National Collegiate Athletic Association Division I (n = 92), club (n = 15), and dance team (n = 41) athletes 18 to 25 years old who attended a large, Midwestern university. Participants completed 4 tests: 2 normed for the general population (Eating Disorders Inventory-2 and Bulimia Test-Revised); a new physiologic test, developed and pilot tested by the investigators, called the Physiologic Screening Test; and the Eating Disorder Exam 12.0D, a structured, validated, diagnostic interview used for criterion validity. RESULTS: The 18-item Physiologic Screening Test produced the highest sensitivity (87%) and specificity (78%) and was superior to the Eating Disorders Inventory-2 (sensitivity = 62%, specificity = 74%) and Bulimia Test-Revised (sensitivity = 27%, specificity = 99%). A substantial number (n = 51, 35%) of athletes were classified as eating disordered/disordered eating. CONCLUSIONS: The Physiologic Screening Test should be considered for screening athletes for eating disorders/disordered eating. The Physiologic Screening Test seems to be a viable alternative to existing tests because it is specifically designed for female athletes, it is brief (4 measurements and 14 items), and validity is enhanced and response bias is lessened because the purpose is less obvious, especially when included as part of a mandatory preparticipation examination.

Journal Article↗

Personality and eating habit variables as predictors of severity of binge eating and weight.

The present study investigated several personality and eating habit variables as predictors of the severity of binge eating and weight deviation. Subjects were 120 normal weight and overweight undergraduate women selected to vary along predetermined dimensions of weight and severity of binge eating. After providing relevant demographic and life history data, they completed a series of self-report questionnaires. Results of a canonical analysis support the independence of binge eating and weight. Two stepwise multiple regressions indicated that anorexic-like eating attitudes, dissatisfaction with body image, and poor self-image were significant predictors of the severity of binge eating while none of the measures was a significant predictor of weight deviation. The amount of stress experienced in the past year was found to be the only significant demographic/historical predictor of binge eating. These findings are discussed with respect to their implications for current understanding of the binge eating phenomenon.

Adolescent↗