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PubMed1997

Selective processing of eating and body words in restricting-type anorexics, binge-eating-type anorexics, bulimics, and control subjects.

A French adaptation of the Stroop colour-naming task was used to investigate selective processing of information related to eating and the body in 92 female subjects: 18 with restricting-type anorexia nervosa (RAs), 25 with binge-eating-type anorexia (BAs), 20 with bulimia nervosa (BNs), and 29 controls (Cs). All participants were significantly slower in colour-naming words related to eating and the body. This suggests that eating and body Stroop effects were not diagnostic category effects. Eating Stroop effect was significantly stronger in eating disordered patients than in Cs, but very similar in RAs, BAs, and BNs. It did not correlate with the body mass index nor with Eating Disorder Inventory (EDI) scores. Body Stroop effect did not differ significantly between groups. However some of our results suggested a tendency for this effect to be higher in BNs, corroborating previous literature data. Body Stroop effect correlated with EDI score in RAs, and with the "body dissatisfaction" subscale score in BNs and BAs. It did not correlate with the body mass index. Further studies are currently being carried out to determine whether inpatient treatment for anorexia nervosa induces significant changes in eating and/or body Stroop effect, and whether such changes might be predictive of clinical outcome.

Adult↗

PubMed1997

Night eating syndrome in individuals with Mediterranean eating-style.

Night eating syndrome is identified with no appetite for breakfast, 50% or more of food intake after 7 p.m. and trouble getting to sleep and/or staying asleep. In a population with a Mediterranean eating style more than 25% of lean healthy subjects should be considered as affected by night eating syndrome, thus making the definition criteria and even the syndrome itself clinically meaningless. Therefore, to assess the presence of night eating syndrome in a population with Mediterranean eating and lifestyle, the following definition criteria were employed: no food or only a little food for breakfast, sleep disturbances and usual consumption of some food just before going to sleep or waking up during sleeptime. According to these criteria, 3.5% of lean subjects should be considered as affected by night eating syndrome, without any relationship between reported psychological distress or tendency to lose control over food intake. Further studies in populations with Mediterranean eating style are mandatory to assess the true clinical significance of night eating syndrome.

Adult↗

PubMedDate not supplied

Binge eating onset in obese patients with binge eating disorder.

In this study we examined whether obese women with binge eating disorder (BED) reporting earlier onset binge eating differed from those with later onset binge eating on salient clinical parameters. Subjects were 112 women who sought treatment for BED. Subjects with early (< or = age 18) and later onset (> age 18) did not differ in age, weight, body mass index, or severity of binge eating. Participants were interviewed using the Eating Disorder Examination (EDE) and the Structured Clinical Interview for DSM-III-R, and completed a weight and diet history questionnaire. Early-onset binge eaters were more likely than those with later-onset to binge-eat before dieting, to have early onset of obesity and dieting, to have longer binge-free periods, and more paternal obesity and binge eating. Early-onset binge eaters also reported more eating-disorders psychopathology, and they were more likely to report a lifetime history of bulimia nervosa and DSM-III-R mood disorder. These data suggest that there are marked differences among BED patients presenting for treatment. Further research is needed to determine whether these differences reflect a different etiology or have implications for treatment.

Adult↗

PubMed2001

Childhood psychological, physical, and sexual maltreatment in outpatients with binge eating disorder: frequency and associations with gender, obesity, and eating-related psychopathology.

OBJECTIVE: To examine rates of reported childhood maltreatment in binge eating disorder (BED), and to explore associations with obesity, gender, eating disorder features, and associated functioning. RESEARCH METHODS AND PROCEDURES: Subjects were 145 consecutive outpatients with BED as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition. Subjects were interviewed and they completed questionnaires to assess eating disorder features and functioning. The Childhood Trauma Questionnaire was given to assess childhood maltreatment in five domains (emotional abuse, physical abuse, sexual abuse, emotional neglect, and physical neglect). RESULTS: A total of 83% of BED patients reported some form of childhood maltreatment. A total of 59% of BED patients reported emotional abuse, 36% reported physical abuse, 30% reported sexual abuse, 69% reported emotional neglect, and 49% reported physical neglect. There were no differences in the distribution of any form of childhood maltreatment by gender or by obesity status. The different forms of maltreatment were not associated with variability in current body mass index, binge eating, or in the attitudinal features of eating disorders. Only one of the five forms of maltreatment (physical neglect) was associated with dietary restraint in women. Emotional abuse was significantly associated with greater body dissatisfaction, higher depression, and lower self-esteem in men and women and sexual abuse was associated with greater body dissatisfaction in men. The different forms of maltreatment were unrelated to the age at onset of overweight, dieting, or binge eating. DISCUSSION: BED outpatients reported a wide range of childhood experiences of maltreatment that do not differ by gender or obesity status. Different forms of maltreatment were not associated with the onset of overweight, dieting, or binge eating, or with variability in current body mass index or eating disorder features (except for one association between physical neglect and dietary restraint). Reports of emotional abuse were associated with greater body dissatisfaction and depression and lower self-esteem in men and women and sexual abuse with greater body dissatisfaction in men.

Adult↗

PubMedDate not supplied

Teasing history and eating disorder features: an age- and body mass index-matched comparison of bulimia nervosa and binge-eating disorder.

The study examined whether a history of being teased about physical appearance is associated with differential patterns of current symptomatology in patients with bulimia nervosa (BN) as compared to patients with binge-eating disorder (BED). Thirty-two adult female patients with BN were compared with an age- and body mass index (BMI)-matched group of 32 adult female patients with BED. A battery of established instruments were used to assess physical appearance-related teasing history, current eating disorder features, body dissatisfaction, and psychological functioning (depression and self-esteem). BN patients reported a significantly higher frequency of having been teased about weight and size (WST) but a similar frequency of having been teased about general appearance (GAT) as the age- and BMI-matched BED patients. The two study groups did not differ significantly on current eating disorder features, body dissatisfaction, or psychological functioning, with the one exception that BN patients were characterized by significantly greater dietary restraint. Correlational analyses conducted separately within the BN and BED study groups revealed few significant associations between teasing history and eating disorder features in either study group. For the BN group, neither WST nor GAT was significantly associated with eating disorder features or body dissatisfaction, but both were significantly associated with lower self-esteem. For the age- and BMI-matched BED group, WST was not associated with eating disorder features, body dissatisfaction, or psychological functioning, but GAT was associated with higher dietary restraint and depression. Although physical appearance related teasing history was not associated with most eating disorder features for either study group, it appears that the association of different forms of teasing with psychological functioning may vary depending on the type of eating disorder symptomatology.

Adult↗

PubMed2004

Application of the Eating Attitudes Test (EAT-26) in a rural, Zulu speaking, adolescent population in South Africa.

This study was undertaken as part of an exploration of the potential risk for future eating disorders in the black female population of South Africa. Previous research has documented eating attitudes suggesting that such a risk exists in urban populations. A translated version of the Eating Attitudes Test (EAT-26) was applied in a Zulu speaking, rural population (n=361). A prevalence of 3% for abnormal eating attitudes was established. In keeping with the hypothesis, the findings suggest that the risk for developing an eating disorder in a rural population is somewhat lower. In this regard, there does appear to be an urban-rural divide, which may have implications for the prevention of the emergence of eating disorders in black, South African adolescents. However, the validity of the EAT-26 in this population is a consideration in interpreting the data.

Journal Article↗

PubMed1995

Controlled study of eating concerns and psychopathological traits in relatives of eating-disordered probands: do familial traits exist?

To examine the extent to which first-degree relatives of eating-disordered (ED) probands endorse maladaptive eating attitudes and personality/affective traits, we compared self-reported eating concerns (Restraint, Emotional Eating, Body Dissatisfaction, and maladaptive eating attitudes) and psychopathological traits (Affective Instability, Anxiousness, Compulsivity, and Narcissism) across groups of restricter (n = 19), binger (n = 56), psychiatric control (PC, n = 38), normal dieter (ND, n = 29), and nondieter control (NC, n = 28) probands, and then across participating nuclear family members. Results among probands were as anticipated: ED probands showed expected elevations in both areas, and predicted restricter/binger differences were obtained. However, corresponding differences were not obtained on measures of mothers', fathers', or siblings' eating concerns and traits. Our findings corroborate the notion that EDs represent a convergence of eating, affective, and personality disturbances, but not that such a clustering of features exists as a familial trait. We discuss normal trait and attitudinal variations observed in ED probands' relatives in light of findings showing EDs and other psychiatric syndromes to aggregate within families.

Adolescent↗

PubMedDate not supplied

Serum leptin level and restrained eating: study with the Eating Disorder Examination.

Serum leptin concentrations in obese patients are influenced at short-term by a reduction of food intake. The objective of this investigation was to evaluate the relationship between serum leptin level and eating behavior. The eating behavior and the food and shape attitudes of a group of obese women were assessed by the Eating Disorder Examination (EDE), and the subscale scores were correlated with serum leptin levels. No difference in serum leptin level was found between obese patients with binge eating disorder (BED) and their nonbingeing counterparts. Considering all patients, the serum leptin levels positively correlated with the body mass index values (BMI), and the EDE subscales scores were positively interrelated. After controlling for BMI, serum leptin level was negatively correlated with the EDE Restraint score and positively correlated with the EDE Shape Concern score. The findings of this investigation indicate that in obese women serum leptin level and the occurrence of binge eating are unrelated. Furthermore, this study also found that the relationship between serum leptin level and restraint over food intake observed in eating disordered patients and in overweight preadolescent girls is shared by obese adult women. In addition, the positive relationship between EDE Shape Concern and serum leptin concentration suggests that the restrained eating might be the cause rather the consequence of the low leptin production.

Adolescent↗

PubMed1999

Measuring binge eating in adolescents: adolescent and parent versions of the questionnaire of eating and weight patterns.

OBJECTIVE: This study investigated the psychometric properties of an adolescent version of the Questionnaire of Eating and Weight Patterns (QEWP-A). METHOD: Male and female adolescents between 10-18 years completed the QEWP-A and measures of depression and eating attitudes. Height and weight were also measured. Parents completed a parental version (QEWP-P) that was referenced to their children. Adolescent and parent responses to the QEWP were independently categorized into no diagnosis (ND), nonclinical binge eating (NCB), and binge eating disorder (BED) groups. RESULTS: Adolescent and parental agreement over the diagnostic categories was as follows: 81.6% for ND, 15.5% for NCB, and 25% for BED with an overall kappa of. 19. Adolescents with BED had significantly higher levels of depression than the other two groups with NCB being higher than ND. For eating attitudes, BED adolescents were more deviant than the other two groups who did not differ from one another. DISCUSSION: The QEWP-A displayed adequate concurrent validity. The low overall agreement between adolescents and their parents was influenced by high and low base rates in the NCB and BED categories, respectively. This lack of agreement is consistent with other behavioral problems such as depression. The data suggest that parental perceptions of eating problems approximate those of their children when no problem is present. However, parents are not as likely to be aware of eating difficulties when they actually exist.

Adolescent↗

PubMed2000

Using the eating disorder examination to identify the specific psychopathology of binge eating disorder.

OBJECTIVE: The clinical features of binge eating disorder (BED) are not well established. Therefore, a comprehensive assessment of the specific psychopathology of BED as compared to anorexia nervosa (AN) and bulimia nervosa (BN) is warranted. This comparison was the aim of the present study. METHOD: Detailed ratings from an investigator-based interview, the Eating Disorders Examination (EDE), were compared across three groups of female patients: those with BED, AN, and BN, as well as normal-weight and overweight control subjects. RESULTS: When comparing BED to AN and BN, patients with BED had lower levels of restraint, eating concerns comparable to AN patients but lower than BN patients, and weight and shape concerns comparable to BN patients but higher than AN patients. Significantly more eating disorder psychopathology was found for BED patients as compared to the overweight controls on all bar the EDE restraint subscale. On the majority of individual EDE items, BED patients' scores were similar to those of AN and BN patients, including importance of shape and weight in self-evaluation and preoccupation with shape and weight. No significant relationship was found between BED patients' degree of overweight and eating psychopathology. DISCUSSION: Our findings support the status of BED as an eating disorder and suggest that the elevated EDE scores reflect the combined impact of being objectively overweight and having disordered cognitions and behaviors about eating, shape, and weight.

Adult↗

PubMed1989

Measuring personal values that are specific to eating: reliability, factors, and eating pattern correlates.

Eating disorders, particularly weight control disorders, appear resistant to long-term modification. While personal values have been shown to influence long-term behavior, their influence on eating patterns has not been studied because of the lack of an instrument to measure those values that are specific to eating. The Eating Values Survey (EVS) was created to measure priorities given to 21 eating-related values, such as sensory qualities of food, the experience of hunger, socializing with others, body appearance, nutritional contribution to health, etc. Responses of 109 male and 99 female university students to the EVS were found stable over a 2-week period and revealed five factors, identified as Gusto, Easy Necessity, Orderliness, Gourmet, and Social Approval. EVS scores also correlated significantly with such self-reported eating disorder variables as being overweight and self-induced vomiting. Sex differences in eating values appeared matters of emphasis rather than of distinction.

Adult↗

PubMed2005

The interaction of personality disorders and eating disorders: a two-year prospective study of patients with longstanding eating disorders.

OBJECTIVE: The current study aimed to investigate the relation between personality disorders and symptoms of both eating disorders and general psychopathology over time. METHOD: Seventy-four patients, with a mean age of 30 years and admitted to a hospital for treatment of a chronic eating disorder, were assessed using the Eating Disorder Inventory (EDI), the Eating Disorder Examination (EDE), the Symptom Check List-90-Revised (SCL-90-R), and the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II) at admission, and after 1 and 2 years. RESULTS: At the 2-year follow-up, there was considerable reduction in both personality and symptoms (effect size = 0.83-0.94). Panel modeling using structural equation modeling techniques indicated that symptomatic changes generally preceded changes in the personality disorder. DISCUSSION: Eating disorder symptoms and general symptomatology had direct effects on a dimensional personality disorder index. Thus, personality disorders may be at least partially a consequence of general symptomatology in chronic eating disorders. Symptom improvement appears to precede changes in personality in this sample of patients with chronic eating disorders.

Adult↗

PubMed2004

Eating disturbances in siblings of patients with eating disorders.

OBJECTIVE: The purpose of this study was to investigate whether siblings of patients with eating disorders show a more disturbed eating behavior and a higher proneness to associated psychological characteristics than controls. METHOD: 84 patients with eating disorders of an outpatient clinic, their siblings (n=84) and a control group (n=84) with an age range 14-34 for the total sample were evaluated using the Eating Disorder Inventory-2. RESULTS: There was no significant difference between the siblings and the controls in disturbed eating behavior. DISCUSSION: The existence of an eating disorder in patients does not seem to be related to the development of eating disturbed behavior in their siblings.

Adolescent↗

PubMed1998

Epidemiology of eating disordered symptoms in the Korean general population using a Korean version of the Eating Attitudes Test.

OBJECTIVE: The purposes of the present study were to estimate the proportion of subjects with a high score on the Korean version of Eating Attitudes Test--26 (KEAT-26), which may provide preliminary data regarding the prevalence rate of eating disorders in the Korean general population, and to further examine the sociocultural hypothesis of eating disorders. METHOD: Using a multi-stage questionnaire sampling method, we surveyed 3062 subjects (1249 males, 1813 females) from 3896 Korean adults in a nationwide area. RESULTS: 8.5% (260/3062) of subjects scored above the cut-off on the KEAT-26. Their demographic correlates, eating traits, and other characteristics relating to general psychopathology were similar to those of patients with eating disorders and female Caucasian controls in Western countries. DISCUSSION: These results suggest that changes in various sociocultural aspects have increased the risk of developing eating disorders in Korea, and support the sociocultural hypothesis of eating disorders.

Adult↗

PubMed2005

Vegetarianism and eating disorders: association between eating attitudes and other psychological factors among Turkish adolescents.

The purpose of this study was to determine whether differences exist in eating attitudes, self-esteem, social trait anxiety and social physique anxiety of self-reported vegetarian and nonvegetarian Turkish adolescents. The sample for the Turkish University' students is designed to provide the estimates of vegetarian indicators and prevalence. The participants were 608 females and 597 males, in total 1205 adolescents aged between 17 and 21 years. Disturbed eating behaviors (EAT-26> or =20) was found in 45.2% (14 of vegetarian) of the total vegetarian sample; which included two of the male vegetarians and 12 of the female vegetarians. The mean BMI was 19.78+/-1.49 kg/m(2) for female vegetarians and 20.78+/-2.46 kg/m(2) for female nonvegetarians (p<0.05). Male vegetarians had significantly higher score than male nonvegetarians on EAT-26 (17.25+/-11.18 for male vegetarians and 9.38+/-6.60 for male nonvegetarians), dieting (6.50+/-7.65 for male vegetarians and 2.55+/-3.87 for male nonvegetarians) and oral control (6.13+/-4.67 for male vegetarians and 3.20+/-3.19 for male nonvegetarians) scores (p<0.05). Besides, female vegetarians had significantly higher score than female nonvegetarians on EAT-26 (22.04+/-13.62 for female vegetarians and 11.38+/-8.28 for female nonvegetarians), dieting (10.35+/-9.58 for female vegetarians and 4.41+/-5.30 for female nonvegetarians), oral control (7.78+/-5.13 for female vegetarians and 3.33+/-3.51 for female nonvegetarians) and STAI (51.39+/-7.28 for female vegetarians and 47.29+/-5.13 for female nonvegetarians) scores (p<0.05). As a conclusion, the present study indicated abnormal eating attitudes, low self-esteem, high social physique anxiety, and high trait anxiety in Turkish vegetarian adolescents. The vegetarian adolescents may be more likely to display disordered eating attitudes and behaviors than nonvegetarians.

Adolescent↗

PubMed2005

The observation and hearing of eating actions activates motor programs related to eating in macaque monkeys.

The observation of actions can lead, in some cases, to the repetition of those same actions. In other words, motor programs similar to those observed can be recruited. Since this phenomenon is expressed when in the presence of another individual, it has been named social facilitation. In the present study we investigated whether the observation and/or hearing of eating actions facilitate eating behaviors in observing/listening pig-tailed macaques. In experiment 1, the observation of an eating room mate significantly enhanced eating behavior in the observer. Similar results were obtained (experiment 2) in response to the sound of eating actions but not to control sounds (experiment 3). We propose that eating facilitation triggered by observation or listening of eating actions can rely on the mirror neuron system of ventral premotor cortex that provides a matching between the observed/listened action and the executed action. This matching system can subsequently trigger the motor programs necessary for repeating the observed/heard actions.

Acoustic Stimulation↗

PubMed2006

The Spanish language version of the Eating Disorder Examination Questionnaire: comparison with the Spanish language version of the eating disorder examination and test-retest reliability.

This study compared the Spanish language questionnaire (S-EDE-Q) and interview (S-EDE) versions of the Eating Disorder Examination and examined the short-term test-retest reliability of the questionnaire version. Seventy-seven monolingual Spanish-speaking Latina women recruited from the community completed the S-EDE-Q and were then administered the S-EDE by fully bilingual doctoral-level research clinicians. The same assessment was repeated after approximately one week (5-14 days). The S-EDE-Q and the S-EDE were significantly correlated on frequencies of binge eating and all four subscales. Mean differences in the frequency of binge eating and the Restraint subscale were not significant, but scores on the Eating Concern, Weight Concern, and Shape Concern subscales differed significantly, with the S-EDE-Q yielding higher scores. Test-retest reliability for the S-EDE-Q was modest for binge eating but was excellent for the subscales (Spearman rho ranged 0.71-0.81), albeit somewhat variable for the individual items. Overall, the acceptable convergence between the S-EDE-Q and the S-EDE for many features of eating disorders and the good short-term test-retest findings provide preliminary support for the use of the S-EDE-Q. These findings, derived using a non-clinical sample of monolingual Spanish-speaking Latina women, require replication and extension. Evaluation with a clinical sample is necessary to further establish the reliability of the S-EDE-Q with an eating disordered group.

Adult↗

PubMed2000

[Eating behavior, eating disorders and obesity].

Over the last 50 years, the nutritional and socioeconomic conditions have dramatically changed in all industrialized countries. As a consequence, there has been a sharp rise in the prevalence of obesity. Simultaneously, social and cultural pressures to maintain a thin body shape have significantly increased. This untoward situation is largely responsible for the steady increase of eating disorders, especially bulimia nervosa and binge-eating disorder, which are common disorders among normal or overweight individuals. Although the criteria for bulimia nervosa were first described in the DSM-III in 1980 (APA, 1980), recent studies have demonstrated that only about 12% of these patients are detected by their GP's. One reason for this low rate of detection may be due to the tendency of patients to conceal their illness from others. It is also possible, however, that general practitioners lack sufficient knowledge about bulimia nervosa, preventing proper identification. To help improve this situation, diagnostic guidelines and therapeutic options were summarized. Binge-eating disorder (BED), which is classified as an "eating disorder not otherwise specified" in the DSM-IV (APA, 1994), has been described as the most relevant eating disorder for overweight individuals. It has been estimated that approximately 20-30% of overweight persons seeking help at weight loss programs are classified as binge eaters. Initial results from these studies suggest that binge eaters may require a modified psychotherapeutic approach which focuses on normalizing disordered eating patterns before attempting weight loss. In addition to the importance of screening for eating disorder behaviors, overweight patients should be assessed for other comorbid conditions, such as depression and anxiety. Further, body image disturbances should be assessed during the evaluation. In the event that comorbid disorders are present, it is recommended that specific psychotherapeutic interventions which target these problems be integrated into the overall weight reduction program.

Anxiety Disorders↗