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Social physique anxiety and disordered eating: what's the connection?

Social physique anxiety (SPA) is highly correlated with other body image measures that have been considered to be important in understanding eating disorders. However, SPA has not been directly studied with respect to eating disorders. Thus, the purpose of this investigation was to examine the link between SPA and measures of eating disorder symptomatology to determine if SPA should be considered as an additional risk factor in the prediction of eating disturbances. One hundred and sixty female undergraduates completed questionnaires measuring body mass index (BMI), social physique anxiety (SPAS), anorexic symptoms (EAT), bulimic symptoms (BULIT-R), depression (CES-D), self-esteem (SES) and obligatory exercise (OEQ). Regression analyses revealed that SPA and depression were the psychological correlates that predicted bulimic symptomatology and that SPA, depression, and obligatory exercise predicted anorexic symptomatology; all variables were positively related to eating disorder symptoms. Overall, the results indicate that social physique anxiety appears to be a useful construct for understanding eating disorder symptoms in female undergraduates.

Adult↗

Using interactive voice response technology and timeline follow-back methodology in studying binge eating and drinking behavior: different answers to different forms of the same question?

As part of a study of the relationship of binge eating, alcohol use, mood, and stressors, we compared the results of two forms of reporting on binge eating and drinking behavior. Forty-three first-year college women participated in an interactive voice response (IVR) study for 12 weeks. Participants answered computer-administered questions daily via IVR technology on number of eating binges and number of alcoholic drinks consumed. After 12 weeks, participants completed a Timeline Follow-back (TLFB) interview retrospectively for number of binges and drinks in the past 12 weeks. Results of this distally retrospective methodology (commonly used in drinking research and applied here also to binge eating) were compared to the results of daily IVR reporting. There was convergence across measures for drinking behavior, but divergence between IVR and TLFB for binge eating reports. TLFB reports underrepresented actual binge eating frequency, which calls into question the validity of applying this methodology to the assessment of binge eating.

Adolescent↗

Negative perceptions about self-control and identification with gender-role stereotypes related to binge eating, problem drinking, and to co-morbidity among adolescents.

PURPOSE: To examine the role of both positive and negative styles of self-control, and gender-role stereotypes in binge eating and problem drinking. METHOD: Participants were 428 adolescent boys and 555 girls from predominantly Anglo-Australian backgrounds who attended regional state schools in New South Wales, Australia. Students completed standardized questionnaires that assessed problem drinking, binge eating, self-control styles, and identification with gender-role stereotypes. ANOVA and post hoc Tukey tests were conducted to examine differences among adolescents who reported problems in binge eating, drinking, and both domains. RESULTS: Adolescents who reported eating and drinking problems also reported a high negative and a low positive sense of self-control coupled with self-identification with the traits that typically describe negative dimensions of gender-role stereotypes. Regardless of gender, problem drinking was mainly related to traits of negative masculinity (bossy, noisy aggressive, etc.) whereas binge eating was mainly related to negative femininity (shy, needs approval from others, etc.). Participants who reported eating and drinking symptoms recorded low scores on positive control, high scores on negative control, and also high scores on the negative dimensions of masculinity and femininity. SUMMARY: A negative and passive style of self-control coupled with an identification with negative dimensions of gender summarizes the type of self-regulation that is implicated in both binge eating and problem drinking, and co-morbid symptoms. There is a need for interventions working toward a more balanced gender self-concept and a positive sense of self-control.

Adolescent↗

Amnestic sleep-related eating disorder associated with zolpidem.

OBJECTIVE: To describe the association of amnestic nocturnal eating behavior with use of zolpidem for insomnia. BACKGROUND: Sleep-related eating disorder is increasingly recognized in relationship to other diagnosable sleep disorders. Many of these disorders, like restless legs syndrome (RLS), give rise to complaints of insomnia. Zolpidem is the most commonly prescribed drug for insomnia complaints, and although it has sometimes been associated with side effects of transient amnesia and sleep walking, an association with sleep-related eating has not been previously emphasized. METHODS: Consecutive case series of five patients who were using zolpidem and evaluated with nocturnal eating behaviors. RESULTS: We evaluated five patients over 11 months with problematic amnestic nocturnal eating associated with zolpidem used for complaints of insomnia. All five patients had RLS, three had obstructive sleep apnea syndrome, two had sleep walking, and one had psychophysiologic insomnia. With discontinuation of zolpidem and effective treatment of their sleep disorders, nocturnal eating resolved. CONCLUSIONS: Zolpidem, at least in patients with underlying sleep disorders that cause frequent arousals, may cause or augment sleep-related eating behavior. This report demonstrates the importance of arriving at a specific diagnosis for insomnia complaints, and alerts the sleep practitioner to this unusual side effect of zolpidem.

Journal Article↗

A two-factor model of disordered eating.

General psychopathology (i.e., personality disturbance, mood/affect dysregulation) has been identified as common and perhaps etiologically important in eating disorder (ED) patients. In this context, we examined a two-factor model of disordered eating which implicated the independent and interactive contribution of (a) general psychopathology (personality) and (b) eating-related psychopathology (body esteem) in explaining deviant eating patterns. A sample of 266 female college/university students (M age=22.1) and 76 women with a clinically diagnosed ED (M age=28.09) completed paper and pencil questionnaires of deviant eating patterns, body esteem, and personality pathology. First, a K-means cluster procedure revealed a compelling three-cluster solution among the nonclinical women based on deviant eating variables: < >(n=61), < > (n=92), and < > (n=103). The ED women were classified as Cluster 4; < > (n=76). Second, to evaluate our two-factor model, multinomial logistic regression (MLR) was used with cluster membership as the outcome variable and the following variables as predictors: body esteem, personality pathology, and all two-way interactions. In addition to several significant main effects, three interaction terms were marginally significant: Body esteem appearance x Narcissism (P=.047), Body esteem weight x Narcissism (P=.044), and Body esteem attribution x Stimulus seeking(P=.051). The overall extent of correct cluster classification was 63%. These results indicate that the presence of both low body esteem and maladaptive personality, and the interactive operation of these two factors, seems to contribute to the likelihood of having an eating disorder, beyond the independent contribution of either factor alone. Results are considered in the context of etiological models in which general psychopathology presents a vulnerability factor in ED development.

Journal Article↗

Negative feelings and the desire to eat in bulimia nervosa.

This study examines a broad range of negative feelings as possible antecedents of binge eating in bulimia nervosa (BN). Another goal is to explore the connection between negative feelings and the desire to eat as recorded continuously during two consecutive days. This is the first study comparing data from BN patients with a relevant clinical control group. Forty female BN patients, 40 female panic disorder (PD) patients, and 40 healthy women continuously recorded their feelings and the desire to eat while in their natural environment. Both patient groups reported more negative feelings than the healthy controls. BN patients had higher within-subject correlations between most negative feelings and the desire to eat than the two control groups. BN patients rated most feelings more negatively in the hour prior to binge eating than during the rest of the day. BN patients' general mood state worsened after binge eating but returned to prebinge levels after purging. The study provides additional evidence that unspecific negative feelings play an important role in the context of binge-eating behavior in BN.

Journal Article↗

Assumptions and beliefs, dieting, and predictors of eating disorder-related symptoms in young women and young men.

Differences between assumptions and beliefs related to eating disorders were investigated in young women and young men, with and without a history of dieting. The unique predictive power of these assumptions and beliefs was also assessed, compared to generic assumptions and beliefs. Both women and men with a history of dieting scored more highly than those who had never dieted on assumptions related to weight, shape, and eating, but did not differ from this group in negative self-beliefs. Assumptions and beliefs related to eating disorders, as well as female gender, but not body mass index (BMI), history of dieting, or generic assumptions and beliefs, predicted eating disorder-related symptoms. The findings add to knowledge about the relationship between assumptions and beliefs, gender, dieting, and eating disorder-related symptoms. They also support the usefulness of the Eating Disorder Belief Questionnaire (EDBQ), a new measure of eating disorder-specific assumptions and beliefs.

Journal Article↗

Emotional eating in overweight, normal weight, and underweight individuals.

Emotional states and situations can affect food intake. We predicted that underweight individuals would eat less and overweight individuals would eat more during negative as well as positive emotional states and situations. Questionnaires to assess eating during emotional states and situations were distributed and collected in person in several major university and public libraries. Ninety questionnaires, representing for each gender the 15 most overweight, the 15 closest to normal weight, and the 15 most underweight, were analyzed. Gender had only minor effects on the eating ratings, and therefore the results are presented for the sexes combined. Underweight individuals reported eating less (P=.000) than both the normal and overweight groups during negative emotional states and situations. More surprisingly, underweight individuals also reported eating more (P=.01) than the other groups during positive emotional states and situations. Thus, part of the prediction was confirmed: the relative undereating by the underweight group, and the relative overeating by the overweight group during negative emotional states and situations. As compared to their usual eating behavior, undereating by underweight individuals during negative emotional states and situations was of a greater magnitude than their own overeating during positive states and situations (P=.01). Undereating by underweight individuals when experiencing negative emotions may contribute to their low body weight.

Journal Article↗

Maternal influences on daughters' restrained eating behavior.

This study examined whether mothers' preoccupation with their own weight and eating was linked to daughters' restrained eating behavior. Participants included 173 non-Hispanic, White mother-daughter dyads, measured longitudinally when daughters were ages 5, 7, 9, and 11. Mothers who were preoccupied with their own weight and eating reported higher levels of restricting daughters' intake and encouraging daughters to lose weight over time. Mothers' encouragement of daughters' weight loss was linked to daughters' restrained eating behavior; this relationship was partially mediated by daughters' perception of maternal pressure to lose weight. These findings suggest that mothers' preoccupation with weight and eating, via attempts to influence daughters' weight and eating, may place daughters at risk for developing problematic eating behaviors.

Body Mass Index↗

Rats (Rattus norvegicus) modulate eating speed and vigilance to optimize food consumption: effects of cover, circadian rhythm, food deprivation, and individual differences.

The eating behavior of rats (Rattus norvegicus) given food pellets of specified size was examined as a function of environmental, circadian, and experiential influences. Eating times were shorter in lighted, exposed environments than in dark, covered environments, even though in novel, exposed conditions the rats made many scanning movements as they ate. Eating time also varied as a function of the circadian cycle in that eating times were shorter in the night portion of the day-night cycle. Finally, eating times decreased if rats were food deprived, and deprivation had a small but enduring influence. Within the tests there were differences in the eating times of individual rats that were not attributable to the experimental manipulations. That rats can optimize food intake by varying eating speed is discussed in relation to physiological regulation of feeding and to optimal foraging theory.

Animals↗

Combined dieting and stress evoke exaggerated responses to opioids in binge-eating rats.

The authors developed an animal model of binge eating where history of caloric restriction with footshock stress (R + S) causes rats to consume twice the normal amount of palatable food. The authors tested the hypothesis that binge eating is mediated by changes in opioid control of feeding by comparing rats' anorectic and orexigenic responses to naloxone and butorphanol, respectively, and by testing the ability of butorphanol to elicit binge eating of chow when palatable food was absent. Mu/kappa opioid-receptor blockade and activation had exaggerated responses in the R + S rats with naloxone suppressing binge eating to control levels, and although butorphanol did not trigger chow binge eating, it enhanced binge eating of palatable food. These responses in sated normal-weight rats strengthen evidence that reward, over metabolic need, drives binge eating.

Analgesics, Opioid↗

Negative regulation of natural killer cell function by EAT-2, a SAP-related adaptor.

EAT-2 is an adaptor expressed in innate immune cells, including natural killer (NK) cells. It is closely related to the adaptor SAP, which regulates signaling lymphocyte activation molecule (SLAM)-related receptors by recruiting the kinase FynT to the receptors. Here we have studied the function of EAT-2 in NK cells by creating mice lacking or overexpressing EAT-2. Like SAP, EAT-2 was associated with the SLAM-related receptor 2B4 in NK cells. However, unlike SAP, EAT-2 was an inhibitor of NK cell function. EAT-2 repressed natural cytotoxicity and interferon-gamma secretion by a mechanism involving tyrosine phosphorylation of its C terminus. We have demonstrated a similar function for the adaptor ERT, a newly identified SAP family member expressed in mouse NK cells. These data identify a previously unknown mechanism of NK cell inhibition. Moreover, they indicate that EAT-2 and SAP have distinct and at times opposing functions in natural immunity.

Adaptor Proteins, Signal Transducing↗

The relationship of childhood adiposity to parent body mass index and eating behavior.

OBJECTIVE: To better understand risk factors for the development of obesity in early childhood, we examined the association between children's adiposity and their parents' eating behavior and body mass index (BMI). RESEARCH METHODS AND PROCEDURES: Parents of 85 white children 36 months of age (49 boys and 36 girls) completed the Three-Factor Eating Questionnaire measuring three dimensions of parent eating behavior: disinhibited eating, cognitive restraint of eating, and susceptibility to hunger. Parent BMI (kg/m2) was calculated using self-reported height and weight. The children's percentage body fat was assessed by dual energy X-ray absorptiometry analysis. RESULTS: Twenty-six percent of parents were obese (BMI > or = 30 kg/m2). Both maternal and paternal BMI were associated with higher scores for disinhibition (r = 0.69 and r = 0.68, p < 0.001), and maternal BMI was also associated with higher scores for hunger (r = 0.51, p < 0.001). There were no significant relationships between children's percentage body fat and parent eating scores, and the correlation between children's percentage body fat and parent BMI was significant only between mothers and daughters (r = 0.35, p = 0.04). Obese parents were no more likely to have a child who was fatter (upper quintile of percentage body fat for gender). DISCUSSION: Among 36 month-old white children, parent eating behavior was related to parent BMI, but not to children's adiposity. There was only a weak relationship between parent BMI and child adiposity. Despite the aggregation of adiposity within families due to shared genes and environments, children may not express differences in susceptibility to obesity by 3 years of age.

Absorptiometry, Photon↗

Self-reported eating behaviors of extremely obese persons seeking bariatric surgery: a factor analytic approach.

OBJECTIVE: To summarize the self-reported eating behaviors of persons seeking bariatric surgery and to provide reliability data for a clinical instrument that assesses those eating behaviors. RESEARCH METHODS AND PROCEDURES: Adults (552) with extreme obesity (mean +/- standard deviation BMI = 52.4 +/- 10.1 kg/m(2)) completed the Weight and Lifestyle Inventory (WALI) before undergoing bariatric surgery. The WALI is a self-report instrument that includes 24 items that assess the eating behaviors to which respondents attribute their excess weight. These items were entered into a principal components analysis with promax rotation. Relationships of factor scores to demographic and psychosocial variables were examined. Test-retest reliability data were obtained from a smaller sample (n = 58) of less obese participants (BMI = 34.4 +/- 4.0 kg/m(2)) who completed the WALI twice within 2 weeks, before beginning a non-surgical weight loss program. RESULTS: The principal components analysis yielded five factors with acceptable internal consistency and test-retest reliability. These included: eating in response to negative affect, eating in response to positive affect and social cues, general overeating and impaired appetite regulation, overeating at early meals, and snacking. Each factor was related to symptoms of binge eating disorder, and every factor except the second one was associated with depressive symptoms. Factor scores were unrelated or weakly associated with demographic characteristics. DISCUSSION: The eating behaviors of persons seeking bariatric surgery can be assessed reliably and parsimoniously with the WALI. The predictive utility of the factors obtained in this study remains to be examined.

Adult↗

Preschool children's eating behaviours are related to dietary adequacy and body weight.

OBJECTIVE: The aim of this paper is to analyse the relationships between eating behaviours (picky eating, irregular eating and overeating), and dietary adequacy in accordance with nutrition recommendations and body weight during the preschool years. DESIGN AND SETTING: Our analyses were performed using data from the Longitudinal Study of Child Development in Québec (1998-2002), a population-based birth cohort. SUBJECTS: The study followed a representative sample (n=2103) of children born in 1998 in the Canadian province of Québec. METHODS: Eating behaviours were derived from self-administered questionnaires when children were 2.5, 3.5 and 4.5 years. Nutrition data were collected from one 24-hour recall interview conducted at home by trained nutritionists at 4.5 years. Children's weight and height were measured at 4.5 years. Statistical analyses were carried out with SAS (version 8.2). Weighted data adjusted for within-variability were used in the analysis, and the significance level was set at 5%. RESULTS: Picky eaters consume fewer total fats, less energy and less protein than children never reporting picky eating behaviours. Picky eaters were more likely to consume less than dietary recommendations for fruit and vegetables, and meat and alternatives. Overeaters consumed more total energy and more of each macronutrient than children who were never reported as overeaters during the preschool years. These children consumed more servings of grain products and meats and alternatives per day than children not classified as overeaters. Even when the number of servings of grain products consumed was similar for overeaters and children who were never overeaters, overeaters had higher body mass index. CONCLUSION: Given that children as young as 4.5 years are displaying some form of problematic eating behaviour which is shown to be related to dietary adequacy and body weight, public health professionals should be targeting parents of young children to provide messages about strategies for coping with problematic eating behaviours in early childhood.

Body Mass Index↗

Cognitive appraisals of dietary transgressions by obese women: associations with self-reported eating behavior, depression, and actual weight loss.

OBJECTIVE: To identify three groups of obese people entering weight loss treatment, who have distinctly different cognitive appraisals of dietary transgressions and to compare these groups on self-report inventories of eating patterns, dieting, and depression, as well as on treatment completion rates and weight loss. DESIGN: Retrospective review of clinical records. Using a measure which evaluates eating-related cognitive appraisals, participants were categorized into one of three cognitive groups (All-or-None, Rationalization, Matter-of-Degree). SUBJECTS: 289 treatment-seeking obese women (age: 40.9 y, body mass index (BMI): 34.7 kg/m2). MEASUREMENTS: Self-reported eating and dieting behavior (Three-Factor Eating Questionnaire and Eating Behavior Inventory); depression (Beck Depression Inventory); attendance information and body weight obtained during treatment. RESULTS: The cognitive group representing objective thinkers (Matter-of-Degree) reported significantly fewer problems with overeating and more personal control over eating than did the rigid, dichotomous thinkers (All-or-None). In addition, the Matter-of-Degree (MAT) group endorsed significantly less subjective hunger and fewer depressive symptoms than the other two cognitive groups. The Rationalization group was more likely to complete a treatment program than was the All-or-None group, with the MAT group not differing from either. Despite these findings, there were no significant differences among cognitive groups on total weight loss. CONCLUSIONS: Cognitive appraisals of weight-control lapses appear to be associated with self-reported eating behavior, depressive symptoms and treatment completion rates, but not with treatment-induced weight loss. The relationship between long-term weight loss and cognitive appraisals of dieting lapses is yet to be determined. It appears necessary to assess empirically the validity of assumptions regarding factors associated with treatment outcome.

Adult↗

Opposite modifications in circulating leptin and soluble leptin receptor across the eating disorder spectrum.

Leptin is thought to modulate feeding behaviour, body weight and energy metabolism by acting through specific cellular receptors. Derangements of leptin production have been repeatedly reported in patients with anorexia nervosa (AN) or bulimia nervosa (BN), but no information has been provided on the functional status of leptin receptors in these disorders. Therefore, we measured plasma levels of leptin and its soluble receptor (Ob-Re) in a total of 130 women, including 22 patients with AN, 45 patients with BN, 18 patients with the binge-eating disorder (BED), 12 non-binge eating obese women and 33 healthy women. Circulating leptin was drastically reduced in underweight anorexics and normal-weight bulimics, but increased in overweight BED patients and non-binge-eating obese women. Conversely, plasma levels of Ob-Re were significantly increased in patients with AN or BN, but decreased in BED and non-binge-eating obese women. Significant inverse correlations were detected between plasma levels of leptin and those of Ob-Re in all the subject groups, except in non-binge-eating obese subjects. These results show, for the first time, that opposite modifications occur in circulating levels of leptin and Ob-Re across the eating-disorder spectrum. The relevance of these findings to the pathophysiology and treatment of eating disorders remains to be elucidated.

Adult↗

Binge-eating episodes are not characteristic of carriers of melanocortin-4 receptor gene mutations.

Recently, Branson and coworkers reported a strong association between binge-eating disorder (BED) and variants in the melanocortin-4 receptor gene (MC4R). In the current study, we compared the eating behavior of 43 obese probands with functionally relevant MC4R mutations and of 35 polymorphism carriers (V103I or I251L) with wild-type carriers. The module for eating disorders of the Composite International Diagnostic Interview was used to identify binge-eating behavior. The Three-Factor Eating Questionnaire and the Leeds Food Frequency Questionnaire were used to assess restrained eating, disinhibition, hunger and percent total energy intake as fat. No significant differences between carriers of MC4R variants and wild-type carriers were detected. In particular, we found no evidence for an increased rate of binge-eating behavior in obese carriers of MC4R variants. Our findings do not support the strong association between BED and MC4R carrier status.

Adolescent↗