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PubMed2003

Binge eating and psychopathology in severely obese adolescents.

OBJECTIVE: The authors describe binge eating and psychopathology in severely obese adolescents who are seeking treatment for obesity and search for specific psychological features that may be associated with binge eating. METHOD: Obese adolescents (n = 102) were assessed with the Binge Eating Scale (BES), the State-Trait Anxiety Inventory for Children (STAIC), the Beck Depression Inventory (BDI), Coopersmith's Self-Esteem Inventory (SEI), and the Body-Esteem subscale from the Piers-Harris Children's Self-Concept Scale (PHCSS). They were also evaluated with the Montgomery and Asberg Depression Rating Scale (MADRS) and the Brief Scale for Anxiety (BSA). Two subgroups (i.e., binge eaters and non-binge eaters) were then established according to the BES score. RESULTS: Binge eating symptoms were frequent in this population and the binge eating dimension was related to high levels of anxiety and depression, as well as to low levels of self-esteem and body-esteem. The dimensions of anxiety and depression were associated specifically with binge eaters. DISCUSSION: As observed in the obese adult population, binge eating symptoms were found frequently in severely obese adolescents seeking treatment and were related strongly to studied parameters. Obese adolescents who binge eat are a subgroup with high psychopathologic distress.

Adolescent↗

PubMed2004

A survey of binge eating and obesity treatment practices among primary care providers.

OBJECTIVES: Obesity is an increasingly prevalent condition and many obese individuals binge eat. It is unclear how much knowledge physicians possess regarding binge eating, but the limited existing data suggest that primary care physicians frequently do not identify obesity as a clinical problem. The objective of this study was to examine physician knowledge and treatment recommendations regarding binge eating and obesity. METHOD: A survey on binge eating and obesity assessment and treatment was mailed to 700 licensed physicians. The survey was returned by 272 (38.9%) respondents. RESULTS: Greater than 40% of physicians never assessed binge eating. Body mass index (BMI) was calculated "often or always" by 36.2% of physicians and "rarely or never" by 39.7%. The pattern of obesity treatment methods offered by providers was quite different from the pattern of treatment requested by their patients. Physicians who made higher estimates of binge eating prevalence were more likely to make treatment referrals. DISCUSSION: In this study, physicians frequently did not assess binge eating. Only a minority of physicians utilize BMI in the assessment and management of obesity. Also, physicians report that the obesity treatments they recommend differ from the treatments patients request of them.

Adult↗

PubMed2002

Gender differences in patients with binge eating disorder.

OBJECTIVE: This study examined gender differences in patients with binge eating disorder (BED). METHOD: Participants were 182 adults (35 male, 147 female) who were consecutively evaluated for outpatient clinical trials and met criteria for BED as outlined in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders. They were administered a battery of measures to examine developmental, eating and weight-related disturbances, and psychological features associated with BED. RESULTS: Men and women did not differ significantly on several developmental variables (age at first overweight, age at first diet, age at onset of regular binge eating, or number of weight cycles). Men had significantly higher current body mass index (BMI), highest adult BMI, and were significantly more likely to be classified as obese. Men and women did not differ significantly on measures of current eating disorder features (binge eating, eating concerns, weight or shape concerns) but women reported significantly greater body image dissatisfaction and drive for thinness. Men and women did not differ significantly on current depression or self-esteem but men reported a greater frequency of past drug abuse problems. DISCUSSION: Although men and women who present for treatment for BED show many similarities in current eating disorder features, we observed a number of gender differences on important developmental and physical variables as well as associated psychological features.

Adult↗

PubMed2006

Binge eating and exercise behavior after surgery for severe obesity: a structural equation model.

OBJECTIVE: The current study sought to find indications for the appropriateness of a model in which eating patterns and exercise beliefs influence binge eating and physical exercise, respectively, that, in turn, influence outcome after gastric banding for severe obesity. METHOD: Participants were 157 patients (144 females, 13 males) who completed questionnaires approximately 34 months (range = 8-68 months) after laparoscopic adjustable gastric banding (LAGB). RESULTS: Our data showed a well-fitting model in which external and emotional eating were associated with outcome through binge eating. Several exercise beliefs were associated with physical exercise, but physical exercise was not associated with weight loss or physical health. CONCLUSION: Binge eating was related more strongly to the outcome after gastric banding than physical exercise. Future research should examine whether a strong focus on the management of binge eating and external and emotional eating could improve the outcome of morbidly obese patients with unsuccessful weight outcome after obesity surgery.

Adult↗

PubMed2007

Cross-ethnic differences in eating disorder symptoms and related distress.

OBJECTIVE: This study investigated ethnic differences in the frequency of eating disorder symptoms and related distress in a U.S. college-based eating disorders screening program. METHOD: Responses to self-report questions and counselors' assessment were analyzed in an ethnically diverse sample (n = 5,435). RESULTS: The frequency of binge-eating, restrictive eating, vomiting, and amenorrhea did not differ significantly across ethnic groups. However, significant between-group differences were found with respect to modes of purging. Binge correlates (e.g., eating until uncomfortably full) were significantly more frequent among Caucasian than African American participants (p < .001). Binge eating was the best predictor of distress among Caucasians, African Americans, and Latinos, whereas vomiting was the best predictor of distress among Asians. Asian participants who used laxatives were significantly less likely to receive a recommendation for further evaluation than non-Asian participants. CONCLUSION: Ethnic diversity in symp tom prevalence and related distress was identified. Clinician recognition of this potential diversity may enhance culturally competent care for eating disorders.

Adolescent↗

PubMed1997

Eating sweet snacks: gender differences in attitudes and behaviour.

This paper reports a study of gender differences in the components of the Theory of Reasoned Action in relation to eating sweet snacks, and the role of these components in predicting sweet-snacking in women and men. Totals of 65 women and 64 men completed questionnaires assessing attitudes and behaviours towards eating sweet snacks. Women were more ambivalent towards eating sweet snacks than men, perceiving eating sweet snacks to be significantly less healthy (t(127) = - 2.43, p < 0.02), and more pleasant (t(127) = 2.52, p < 0.01). There were no statistically significant gender differences in outcome beliefs x evaluations, subjective norms, normative belief x motivation to comply, or in behavioural intention, although some gender differences were found within components. Women scored significantly higher (t(127) = 5.54, p < 0.0005) on restraint items from the Dutch Eating Behaviour Questionnaire, including those on snacking (t(127) = 5.04; p < 0.0005), but did not differ significantly from men on reported frequency of eating sweet snacks. There were gender differences in the predictive power of components of the Theory of Reasoned Action. Women's intentions to eat sweet snacks were predicted by perceived social pressure and attitudes towards sweet snacks. Men's intentions were only predicted significantly by attitudes. It is concluded that men's sweet-snacking is less influenced by social pressure than is women's.

Adolescent↗

PubMed2000

Emotions and eating in everyday life.

This field study assessed emotional states experienced in everyday life and examined the subjective motivation to eat associated with these emotional states. Twenty-three female subjects rated their momentary emotional state and motivation to eat on 6 consecutive days at 11:00a.m., 2:00p.m., 5:00p.m., 8:00p.m. and 11:00p.m. A cluster analysis of the resulting 634 emotion profiles revealed three types of emotional states characterized by the labels "Anger-dominance", "Tension/Fear" and "Relaxation/Joy". A fourth cluster showing generally low levels of emotions was labelled "Unemotional state". Most of the self-rated motivations to eat were increased during periods of negative emotions. During negative emotions a heightened tendency to cope with these emotions through eating and more intense bodily symptoms of hunger were also reported. No differences in motivations to eat were found between the two negative emotion clusters or between relaxation/joy and the unemotional state. Results indicate the presence of "emotionally instrumental eating" in a non-clinical population under real life conditions. Physiological correlates of negative emotional states may be involved in emotionally instrumental eating.

Adult↗

PubMed2001

Body weight, body-weight concerns and eating styles in habitual heavy users and non-users of artificially sweetened beverages.

This study investigated reported body weight, concerns about body weight and eating styles in habitual heavy users (consume>825 ml/day) and habitual non-users of artificially sweetened beverages (ASBs). Groups of habitual heavy users (N=51) and non-users (N=69) were compared on measures of weight using self-reported body mass index (BMI), and measures of weight concern and eating style using the Dutch Eating Behaviors Questionnaire (DEBQ), the Yale Eating Patterns Questionnaire (YEPQ), and the Eating Disorder Inventory (EDI). Habitual heavy users reported higher body weights (BMI), greater concerns about weight and greater tendencies toward certain eating styles, when compared to non-users. Using logistic regression, 82% of respondents were correctly classified as heavy or non-users of ASBs using body mass index and body-weight concerns. Associations between a heavy use of ASBs and certain eating styles can be explained by association with high body weights and concerns about body weight.

Beverages↗

PubMedDate not supplied

Eating disorders.

Anorexia nervosa and bulimia nervosa are primarily psychiatric disorders characterized by severe disturbances of eating behaviour. Anorexia nervosa has been well documented in pre-pubertal children. Eating disorders are most prevalent in the Western cultures where food is in abundance and for females attractiveness is equated with thinness. Eating disorders are rare in countries like India. As Western sociocultural ideals become more widespread one may expect to see an increase in number of cases of eating disorders in non-Western societies. Etiological theories suggest a complex interaction among psychological, sociocultural, and biological factors. Patients with anorexia nervosa manifest weight loss, fear of becoming fat, and disturbances in how they experience their body weight and shape. Patients with bulimia nervosa present with recurrent episodes of binge eating and inappropriate methods of weight control such as self-induced vomiting, and abuse of diuretics and laxatives. Major complications of eating disorders include severe fluid and electrolyte disturbances and cardiac arrhythmias. The most common cause of death in anorexia nervosa is suicide. Management requires a team approach in which different professionals work together. Individual and family psychotherapy are effective in patients with anorexia nervosa and cognitive-behavioral therapy is effective in bulimia nervosa. Pharmacotherapy is not universally effective by itself. Patients with eating disorders suffer a chronic course of illness. The pediatrician plays important role in early diagnosis, management of medical complications, and psychological support to the patient and the family.

Adolescent↗

PubMed2003

Binge eating disorder versus overeating: a failure to replicate and common factors in severely obese treatment seeking women.

The disordered eating symptoms, general psychopathology and dieting history among obese women diagnosed with Binge Eating Disorder (BED) and obese women who overeat (OE) are examined. One hundred and thirty women (n=83 with BED and n=47 who overeat) seeking treatment for an eating disorder were diagnosed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria and the Eating Disorders Examination (EDE). They also completed a battery of psychometric tests. Despite adequate statistical power to detect differences, MANOVAs revealed very few significant differences between the groups. Loss of control of eating does not adequately differentiate these two groups within an eating disorders treatment-seeking context. It is likely that only the most acutely distressed from each group is seeking treatment, so that differences found in a community sample would not be found. Using a principal components analysis, factors within each group that may underlie the common psychopathology of both groups (i.e. disordered eating symptoms, general psychopathology and dieting history) were found.

Adult↗

PubMed2006

Relationship between spiritual well-being and binge eating in college females.

The aim of this study was to examine the relationship of spiritual well-being in college female non-binge, objective binge and binge-trait eaters. Therefore, this study aimed to measure spiritual well-being in non-binge, objective binge and partial/full-syndrome binge eating disorder college females. Survey research was conducted using a randomized sample of 809 female students. The sample was categorized into three binge eating categories: nonbinge, objective binge, and binge eating trait. Chi-Squares and Analysis of Variance determined binge eating group differences on demographics, global spiritual well-being, religious well-being, and existential well-being. Significant differences were found among groups for global spiritual well-being (p< or = 0.000), religious well-being (p< or = 0.000), and existential well-being (p< or = 0.000). Higher levels of binge eating severity were associated with lower global spiritual and existential well-being scores. On measures of religious well-being, significant differences existed between the non-binge and the binge eating trait groups. The results suggest that spiritual well-being and especially existential well-being may be indirectly associated with the severity of binge eating.

Adolescent↗

PubMed1999

Binge eating disorder in males: a population-based investigation.

The authors investigated the prevalence of binge eating behavior in a general male Austrian population. A randomly selected sample of 1000 male adults aged 18 to 88 was interviewed by dieticians over the phone. Some screening instruments were used to detect binge eating behavior. The results showed a total prevalence of eating disorders of 14.9%. Eight subjects (0.8%) met the full diagnostic criteria for binge eating disorder (BED), 42 (4.2%) exhibited a partial binge eating syndrome, 94 (9.4%) an Eating Disorder Not Otherwise Specified, and five subjects (0.5%) a bulimia nervosa. Most subjects with a eating disorder were overweight or obese, particularly those with a full BED syndrome. Our findings indicate that full BED syndromes are very rare in a nonclinical male sample, whereas partial syndromes are fairly common in males.

Adolescent↗

PubMed1998

Validation and reliability of the Italian EAT-26.

The Italian from of the short, 26-item Eating Attitudes Test (EAT-26) has been administered to 1277 Roman high-school students, mostly females, as a screening device. Ninety-five students with a total score > 20 and 40 students with a low score, were randomly selected, interviewed and diagnosed. The EAT-26 proved to be more sensitive to the presence of an eating disorder than to a specific clinical entity. Item analysis performed on the EAT-26 variables showed satisfactory reliability coefficients. Factor analysis using an oblique rotation was similar to that obtained by Garner et al. (1). Factor analysis with an orthogonal rotation (Cattell's screen test) identified five factors. Results suggested that the EAT-26 isolates cases at risk of clinical spectrum eating disorders.

Adolescent↗

PubMed1998

The Eating Attitudes Test: comparative analysis of female and male students at the Public Ballet School of Berlin.

Differentiated examination of eating attitudes and behaviours of female and male German ballet school students with particular reference to their age and analysis of common points with and differences from female Anorexia nervosa (A.n.) patients. The Eating Attitudes Test (EAT-40) was used. Male and female adolescent students of a ballet school and a high school as well as anorectic patients participated in this study. EAT totals exhibited by female and male ballet school students were higher with significance than those recorded from high school students. EAT totals > 30 were reached by 21.6% of female ballet school students but by no male ballet school student at all. In the context of certain EAT items, a number of differences are described between female ballet school students, on the one hand, and female A.n. patients, on the other. No case was identifiable which would satisfy ICD-10 criteria for Anorexia nervosa. Attitudes and behaviours of adolescent female and male ballet dancers toward eating and their own body should be judged with due consideration of their specific living conditions.

Adolescent↗

PubMedDate not supplied

Obsessionality in eating-disorder patients: relationship to clinical presentation and two-year outcome.

Obsessionality and obsessive-compulsive symptoms have been regarded as important characteristics in the clinical presentation of the eating disorders. In this report, we examined the relation between obsessionality and the clinical presentation and outcome of a sample of eating-disordered patients. Self-rated obsessional symptoms, defined by the obsessive-compulsive subscale of the Symptom Checklist 90 (revised version), were compared with presenting clinical symptomatology, and scores on the Eating Disorder Inventory (EDI) and Beck Depression Inventory (BDI) in a sample of 110 consecutively evaluated women who met DSM-IIIR criteria for eating disorders. Forty patients were contacted for a follow-up investigation, 2 years after the initial evaluation. Higher obsessive-compulsive subscale scores at presentation were associated with more severe dieting, a greater number of psychiatric hospitalizations, and higher EDI, SCL-90R and BDI scores. Initial obsessive-compulsive scores did not predict the subsequent outcome of a sample of these patients in the community. However, elevated obsessive-compulsive scores obtained at follow-up were associated with the presence of lower body weight and more severe eating-disorder symptoms at that time. These results support the hypothesis that elevated obsessionality is associated with more severe eating disorder symptomatology. In addition, obsessional symptoms change along with those of the eating disorder, and their persistence may be associated with a poorer outcome.

Adolescent↗

PubMed1975

Pavlovian conditioning of eating induced by spreading depression in cortex, striatum and hippocampus of rats.

A single wave of unilateral spreading depression in the cortex, hippocampus or caudate nucleus of rats elicits eating after 2-6 min. The present experiments provide evidence that such spreading depression-induced eating can be classically conditioned to a complex conditioned stimulus. A wave of spreading depression was triggered by injection of 0.5-2.0 mul of 25 percent KCl solution. In a first experiment successful conditioning was demonstrated in 20 rats, involving 7 cortical, 5 caudate and 8 hippocampal spreading depression sites. Four animals failed to show any conditioned eating. A control group of 8 animals, in which cortical spreading depression did not induce eating, showed no increase in eating in the presence of the CS after conditioning trials. A second experiment, which included pseudoconditioning and NaCl control groups, confirmed the results obtained in Experiment 1. Classical conditioning was successful in 11 animals, involving 6 cortical and 5 caudate spreading depression sites. Neither the pseudoconditioning (14 animals, involving 8 cortical and 6 caudate spreading depression sites) not the NaCl control group (8 animals, all with cortical sites), showed eating in the presence of the CS. In both experiments the conditioned eating underwent gradual extinction.

Animals↗

PubMed1983

Eating attitudes and behaviors of anorexia nervosa patients and their sisters.

Although the sisters of anorexia nervosa patients may have an increased risk for this disorder, there are no controlled studies of the eating patterns and attitudes of the normal sisters of anorexic patients. Twenty-one sister pairs (anorexics and their normal sisters) were interviewed and given the Eating Attitude Test (EAT) to compare their eating attitudes and behaviors. The mean scores on the EAT and its three subscales (measuring "Dieting," "Bulimia and Food Preoccupation," and "Oral Control") were significantly correlated with criterion group membership (p less than 0.0001). The normal sisters as a group did not demonstrate anorexic eating attitudes. However, two normal sisters did score in the anorexic range and are being followed prospectively. The EAT questionnaire could be used to screen vulnerable siblings of patients with anorexia nervosa for early signs of this disorder.

Adolescent↗

PubMed1985

Assessing generalization of treatment effects and self-efficacy in the modification of eating styles in obese children.

The present study implemented a brief behavioral treatment program designed to alter the eating styles of 16 obese children and assessed the generalizability of children's eating styles from a laboratory setting to a school cafeteria. Results indicated that obese children exhibited significantly different eating styles at different mealtimes across the two settings. The treatment program was also found effective in altering eating styles in both settings. Although no significant differences between the eating styles of obese and normal weight children were observed prior to treatment, the 2-week follow-up observation in the natural setting demonstrated a different eating style between obese and normal weight peers. Results also indicated that a self-efficacy rating scale was no more effective than a control measure in predicting post-treatment eating styles.

Behavior Therapy↗