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PubMed2004

Validation of the Dutch Eating Behaviour Questionnaire parent version (DEBQ-P) in the Italian population: a screening tool to detect differences in eating behaviour among obese, overweight and normal-weight preadolescents.

OBJECTIVE: To validate the Dutch Eating Behaviour Questionnaire Parent version (DEBQ-P) in the Italian population and investigate the differences in eating behaviour among Italian normal-weight, overweight and obese preadolescents. DESIGN: A cross-sectional validation study. Participants were measured and the approved translation of the questionnaire was administered to their parents. SETTING: : Three school communities in the province of Bergamo, Northern Italy. SUBJECTS: A total of 312 preadolescents (mean age 12.9 y; s.d. 0.8, both sexes) from three secondary schools of the province of Bergamo, Northern Italy, and their parents were invited to participate to the study. Informed written consent was obtained from each subject and their parents. Students were measured and their parents filled in the approved translation of the DEBQ-P. Recruitment was opportunistic and school based. RESULTS: Factor and internal consistency analysis confirmed the factor structure of the DEBQ-P and the high internal consistency of its three scales. Variance analysis showed that eating behaviour of Italian normal-weight, overweight and obese preadolescents differs significantly only in regards to the 'restrained eating' scale (F 19.29, P < 0.001), with overweight and obese scoring higher. CONCLUSIONS: The DEBQ-P can be used for screening projects regarding eating behaviour in the Italian population. The association between restrained eating and weight status was confirmed for both sexes, but the relationship between external eating and emotional overeating and overweight requires further exploration.

Adolescent↗

PubMed1999

Personality and affectivity characteristics associated with eating disorders: a comparison of eating disordered, weight-preoccupied, and normal samples.

The purpose of this study was to assess the relative contribution of personality and emotional experience to self-reported eating attitudes in a group of patients with clinically diagnosed eating disorders, a weight-reduction training group (Weight Watchers), and a control group without body weight problems. Participants in this study (N = 114) completed Estonian versions of the Eating Disorder Inventory-2 (EDI-2; Garner, 1991), NEO Personality Inventory (Costa & McCrae, 1989), and Positive Affect and Negative Affect Schedule, Expanded Form (Watson & Clark, 1994). Data demonstrated validity of the Estonian version of EDI-2 in its ability to identify problems on a continuum of disordered eating behavior. Among the Big Five personality dimensions, Neuroticism made the largest contribution to EDI-2 subscales. Two other dimensions, Openness to Experience and Conscientiousness, also predispose individuals to eating problems. Personality traits made a larger contribution to the self-reported eating pathology than the self-rated effects experienced during the last few weeks. It was argued that personality dispositions have a larger relevancy in the etiology of eating disorders than emotional state.

Adolescent↗

PubMed2006

Pre-surgery binge eating status: effect on eating behavior and weight outcome after gastric bypass.

BACKGROUND: The impact of pre-surgical binge eating on postoperative outcomes is poorly understood. Previous studies have found marked preoperative differences between binge eaters (BE) and non-binge eaters (NBE) in hunger and disinhibition using the Three-Factor Eating Questionnaire (TFEQ). Short-term prospective data are mixed regarding whether these differences persist after surgery and if preoperative binge eating impacts postoperative weight outcomes. The purpose of the present study was to compare self-reported eating behavior and weight outcomes between BE and NBE after the first postoperative year. METHODS: Prior to surgery, 72 Roux-en-Y gastric bypass (RYGBP) patients completed the Questionnaire of Eating and Weight Patterns (QEWP) or QEWP-Revised (QEWP-R), to assess binge eating status which was defined as one objective binge episode per week over the past 6 months. Subjects also completed the TFEQ prior to surgery and again > or = 12 months after surgery. RESULTS: For BE, higher scores were found for both hunger and disinhibition prior to surgery. At a mean of 18 months after surgery, BE and NBE were indistinguishable on these subscales and there were no differences in weight lost. CONCLUSIONS: RYGBP surgery has an equally positive impact on eating behavior and weight loss for both BE and NBE. Within a multidisciplinary clinic, preoperative BE status does not appear to be a negative prognostic indicator for RYGBP surgery in the domains of weight loss and disinhibition. Further replication is needed with longer follow-up times and larger samples.

Adult↗

PubMed2000

Comorbid psychopathology in binge eating disorder: relation to eating disorder severity at baseline and following treatment.

Individuals with binge eating disorder (BED) have high rates of comorbid psychopathology, yet little is known about the relation of comorbidity to eating disorder features or response to treatment. These issues were examined among 162 BED patients participating in a psychotherapy trial. Axis I psychopathology was not significantly related to baseline eating disorder severity, as measured by the Structured Clinical Interview for DSM-III-R (SCID-I and SCID-II) and the Eating Disorder Examination. However, presence of Axis II psychopathology was significantly related to more severe binge eating and eating disorder psychopathology at baseline. Although overall presence of Axis II psychopathology did not predict treatment outcome, presence of Cluster B personality disorders predicted significantly higher levels of binge eating at 1 year following treatment. Results suggest the need to consider Cluster B disorders when designing treatments for BED.

Adult↗

PubMed1995

Curative and protective effects of IL-10 in experimental autoimmune thyroiditis (EAT). Evidence for IL-10-enhanced cell death in EAT.

We studied the effects of in vivo administration of rhIL-10 in two models of experimental autoimmune thyroiditis (EAT): 1)-in EAT induced by injection of mTg emulsified in adjuvant, and 2) in EAT induced by adoptive transfer of mTg-specific T lymphocytes. Furthermore, we tried to assess both the protective and curative potential of IL-10 in EAT, by administering rhIL-10 either at the time of priming and challenge with mTg, or only at the time of challenge. We demonstrated that proliferative and cytotoxic responses of splenic cells to mTg were markedly reduced by in vivo rhIL-10 treatment. Cell surface marker studies revealed a 40 to 45% reduction in CD4+ and in CD8+ lymphoblastoid spleen cells from mice treated with rhIL-10 either in the early or in the late EAT. The severity of EAT was significantly reduced in mice treated with high-dose rhIL-10, whereas levels of autoantibodies to mTg were not altered. Furthermore, when analyzing purified T lymphocytes from rhIL-10-treated animals, an increase of cells undergoing apoptotic cell death became evident in the rhIL-10 treated group, as compared with controls. This IL-10-mediated enhancement of activation-induced cell death critically depended on the applied therapeutic dose of rhIL-10. Thus, IL-10 exerts beneficial effects on the development and course of EAT through a mechanism that could imply an IL-10-mediated enhancement of activation-induced cell death in T lymphocytes, findings that call for considering IL-10 in the immunotherapy of early-phase and likewise of already established autoimmune thyroiditis.

Adjuvants, Immunologic↗

PubMed1993

Binge eating disorder should be included in DSM-IV: a reply to Fairburn et al.'s "the classification of recurrent overeating: the binge eating disorder proposal".

Extensive recent research supports a proposal that a new eating disorder, binge eating disorder (BED), be included in DSM-IV. BED criteria define a relatively pure group of individuals who are distressed by recurrent binge eating who do not exhibit the compensatory features of bulimia nervosa. This large number of patients currently can only be diagnosed as eating disorder not otherwise specified (EDNOS). Recognizing this new disorder will help stimulate research and clinical programs for these patients. Fairburn et al.'s critique of BED fails to acknowledge the large body of knowledge that indicates that BED represents a distinct and definable subgroup of eating disordered patients and that the diagnosis provides useful information about psychopathology, prognosis, and outcome (Fairburn, Welch, & Hay [in press]. The classification of recurrent overeating: The "binge eating disorder" proposal. International Journal of Eating Disorders.) Against any reasonable standard for adding a new diagnosis to DSM-IV, BED meets the test.

Anorexia Nervosa↗

PubMed1996

Influences of gender, amount of food, and speed of eating on external raters' perceptions of binge eating.

Traditional methods for examining binge-eating (e.g. food diaries, laboratory binges), primarily employing clinical samples, have a number of limitations. This paper details three studies utilizing a new methodology to examine perceptions of binge eating: standard videotapes of male and female models consuming doughnuts. College students (n = 459) viewed one of nine videotapes and were asked if the eating behavior of the model was a binge or not. Variables manipulated include gender of the model, number of doughnuts, rate of eating and social (vs. solitary) eating. The number of doughnuts eaten by a female model was sufficient for female subjects to label it as a binge. In order for a male to have binged, females responded to the amount; males required both speed and amount. Results are discussed in terms of their relevance for understanding perception of binge eating in normal and clinical populations.

Adolescent↗

PubMed1996

The eating attitudes test and the eating disorders inventory in four Bulgarian clinical and nonclinical samples.

OBJECTIVE: As part of the International Collaborative Study of Eating Disorders in Adolescence, with sites in West and East Berlin, Zurich, and Sofia, eating attitudes and disorders were studied in four Bulgarian samples. METHOD: The Eating Attitude Test (EAT) and the Eating Disorders Inventory (EDI) were used in this study. Besides a clinical group of anorectic patients, students attending either a special secondary school, a standard secondary school, or a sports school participated in this study. RESULTS: Findings revealed excellent discriminant validity of the EAT total score and the three subscales. This also applied to four out of eight subscales of the EDI. Discriminant validity was less satisfactory in three further scales and entirely missing for Maturity Fears. DISCUSSION: The findings are discussed in a transcultural perspective.

Adolescent↗

PubMed1999

Night eating and binge eating disorder in obese patients.

OBJECTIVE: To investigate the relationships between binge eating disorder and night eating in severely obese patients. DESIGN: Longitudinal study following biliopancreatic diversion, when any preoccupation with food and weight is completely abandoned. MATERIALS AND METHODS: Structured interview prior to the operation and at the 1, 2, and 3-year follow-up visit. RESULTS: Nearly complete disappearance of binging behavior and no changes in the frequency of night eating. CONCLUSION: Binge eating and night eating are widely overlapping but different behaviors; night eating appears to be fully independent of preoccupation with food and dieting.

Adult↗

PubMed2003

Clinical course and short-term outcome of hospitalized adolescents with eating disorders: the success of combining adolescents and adults on an eating disorders unit.

Although significant controversy exists regarding the appropriate setting for treating adolescents with eating disorders, empirical studies have been lacking. This study aimed to evaluate, and compare with adults, the clinical course and short-term outcome of adolescents with eating disorders hospitalized on an adult eating disorders unit. One hundred forty-four consecutive inpatient admissions on a weight gain protocol (28% minors and 72% adults) completed psychometric measures and were assessed on clinical indices. No differences between minors and adults were demonstrated for weight gain per week on either inpatient or partial hospitalization admissions. Whereas inpatient length of stay was equivalent, adolescents stayed significantly longer in partial hospitalization than adults. Minors did not differ from adults on the presence of problematic eating disordered behaviors or most psychometric measures, although they had less functional interference due to their eating disorders. Results suggest that an adult eating disorders specialty program can be an appropriate and efficacious setting for adolescents.

Adolescent↗

PubMed2001

Eating concerns in East Asian immigrants: relationships between acculturation, self-construal, ethnic identity, gender, psychological functioning and eating concerns.

OBJECTIVE: Eating concerns in East Asian immigrants were assessed and their association with acculturation status, self-construal, ethnic identity, gender and psychological functioning was examined. METHOD: One-hundred and fifty non-clinical East Asian immigrants (75 males, 75 females) were administered a battery of psychometrically established measures with satisfactory reliability and validity. RESULTS: Females were more prone to eating concerns and these were positively related to symptoms of psychological distress. Acculturation, self-construal, ethnic identity and psychological functioning were not related to desire to be thinner, feeling guilt after eating, fear of being overweight nor preoccupation with the thought of having fat on one's body. Collective self-esteem and symptoms of psychological distress were positively related to feeling discomfort after eating sweets, while interdependent self-construal and assimilation were negatively related. DISCUSSION: Culturally relevant variables, namely acculturation, self-construal and ethnic identity, were related to only certain facets of eating concerns. The findings suggest the importance of assessing discrete, psychologically-relevant facets of culture rather than more global constructs such as westernization when examining eating concerns in immigrant populations.

Acculturation↗

PubMed2004

Chewing and spitting in eating disorders and its relationship to binge eating.

OBJECTIVE: This study examined (i) the frequency of chewing and spitting and (ii) its association with other pathological eating behaviors in eating-disordered inpatients. We hypothesized a positive association between chewing and spitting and binge eating given the phenomenological similarities between these disordered eating behaviors. METHOD: Frequent chewers/spitters were compared with those who did not regularly engage in this behavior with regard to diagnosis, psychometric test results, and associated eating pathology. RESULTS: Chewing and spitting was not associated with elevated bingeing. Rather, frequent chewers/spitters exhibited higher levels of restrictive eating behaviors and the behavior was more prevalent in younger patients. DISCUSSION: Contrary to our predictions, chewing and spitting is more closely associated with restrictive than with binge behaviors. This suggests that most individuals chew and spit small portions of food. The behavior is frequent, occurs across diagnostic groups, and may be associated with greater psychopathology. Future studies should clarify the amount of food consumed during chew/spit episodes and the presence of a sense of loss of control.

Adult↗

PubMed2001

Eating disorders and altered eating behaviors in adolescents of normal weight in a Spanish city.

PURPOSE: To study the prevalence of altered eating behaviors or eating disorder-related behaviors among adolescents of normal weight that do not fulfill criteria for anorexia nervosa and bulimia nervosa. METHOD: Cross-sectional study by means of a self-completed questionnaire (School of Nutrition of Granada, Spain) and measurement of weight and height in a population of 491 schoolchildren aged 14-18 years. The statistical inferences and estimation of risk are based on comparison of proportions and means test, and the relative inequality of prevalences. RESULTS: Of 491 adolescents of normal weight, 9% (females 2:1) were following diets; 42% presented "recurrent episodes of binging" with the sensation of loss of self-control; and 41%% avoided specific types of food. Overall, 46.2% presented altered eating behavior. Factors significantly associated with this were the occurrence of periods of food abstinence and the use of purgatives [confidence interval 95% (CI 95%) prevalence ratio (PR) 1.41-2.02]. Compensatory behaviors were present in 33% of the adolescents, predominantly in females (CI 95% PR 1.79-3.07). The prevalences of abnormal eating behaviors were 16.3% for those related to anorexia (A-RB) and 17.1% for those related to bulimia (B-RB), with a clear predominance of females (2:1) and public education. There seems to be a greater aesthetic concern among those with B-RB and more worry about weight among those with A-RB. CONCLUSIONS: A high proportion of adolescents with abnormal eating behaviors and an altered perception of body fat may currently be diagnosed as having atypical eating disorder" (Diagnostic and Statistical Manual of Mental Disorders, Fourth Revision) considering that their body mass index was within normal range.

Adolescent↗

PubMed1997

Reports of stress: a comparison between eating disordered and non-eating disordered adolescents.

This study utilizes a unique method to examine reports of stressful life events provided by eating disordered and non-eating disordered adolescents. Subjects (all females) participated in a standardized procedure to obtain reports of stressful life events. The Life Events and Coping Inventory (LECI) was used to categorize reported stressors. Eating disorder subjects discussed more stressors than non-eating disorder subjects only when eating disorder events were included. Furthermore, eating disorder subjects reported more events that could not be classified within the LECI and were rated as non-normative. The findings point to the importance of qualitative rather than purely quantitative approaches to stressful life events assessment with adolescents.

Adaptation, Psychological↗

PubMed2000

Development and validation of the Eating Disorder Diagnostic Scale: a brief self-report measure of anorexia, bulimia, and binge-eating disorder.

This article describes the development and validation of a brief self-report scale for diagnosing anorexia nervosa, bulimia nervosa, and binge-eating disorder. Study 1 used a panel of eating-disorder experts and provided evidence for the content validity of this scale. Study 2 used data from female participants with and without eating disorders (N = 367) and suggested that the diagnoses from this scale possessed temporal reliability (mean kappa = .80) and criterion validity (with interview diagnoses; mean kappa = .83). In support of convergent validity, individuals with eating disorders identified by this scale showed elevations on validated measures of eating disturbances. The overall symptom composite also showed test-retest reliability (r = .87), internal consistency (mean alpha = .89), and convergent validity with extant eating-pathology scales. Results implied that this scale was reliable and valid in this investigation and that it may be useful for clinical and research applications.

Adolescent↗

PubMed2003

[Differences between female and male patients with eating disorders--results of a multicenter study on eating disorders (MZ-Ess)].

Publications about men with eating disorders are still rare. Therefore, in view of the current status of the findings, it seems worthwhile to examine the differences that are empirically verified as well as the relevant common features between the sexes. Based on a representative sample, therefore, male and female patients with eating disorders in inpatient treatment are compared in terms of demographic and clinical variables (symptoms and personality), both at the beginning of treatment and two-and-a-half years after the inpatient treatment, and the findings are discussed with regard to their "gender specificity". The study covered 1,171 patients (male and female) with the diagnosis criteria for anorexia, bulimia and double diagnosis according to DSM-III-R; 33 of them were men. Anorexia cases (342 women and 13 men) and bulimia cases (629 women and 18 men) were compared at the beginning of treatment with the following instruments: Symptom Checklist 90-R; Eating Disorder Inventory; questionnaire for the symptom diagnosis of eating disorders; Freiburger Persönlichkeitsinventar and Narzissmus-Inventar. As a measure of success in the 2.5 year catamnesis (764 women and 20 men), operationalized criteria were defined using the LIFE. The 2.8 % share of men with eating disorders in inpatient treatment again confirms the special nature of this clinical disorder for men. An interesting result is the later onset of illness in male anorexia cases. Coinciding with comparable studies, there are only minor differences in eating behavior, but the differences in body experience are much more pronounced. In bulimic men, there is a higher percentage of homosexuals and they are more satisfied with their body. Anorectic men have a greater gain from the illness, are more concerned about their health and are less performance-minded than female anorectics. The differences that were found clearly indicate that these occur especially in the area of dealing with the body and the significance of the body. One of the reasons why the results in the area of personality and sexual identity are interesting is that they point to differences which definitely appear to be significant, not just between the sexes, but also between male anorexia and bulimia.

Adult↗

PubMedDate not supplied

Report on a panel longitudinal study of college women's eating patterns and eating disorders: noncontinuum versus continuum measures.

The self-reported frequencies (prevalence and incidence) of eating patterns and disorders in a matched longitudinal sample of college women (N = 141) interviewed during their sophomore year (Time 1) and senior year (Time 2) were compared. The rate of eating disorders was assessed using a noncontinuum measure, the Eating Attitudes Test (Garner, Olmsted, Bohr, & Garfinkel, 1982), as well as continuum measures based on criteria in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1980). The noncontinuum measure revealed a prevalence rate of eating disorders per 2-year period comparable to that found in other studies of college student populations. The incidence rate per 2-year period was not of epidemic proportions. A sizable percentage of women appeared to get better from Time 1 to Time 2; a small percentage of women remained abnormal eaters. The continuum measurement uncovered a large group of women whose eating patterns were chronic but not severe enough to classify them as "abnormal" eaters. The implications of using different measures for defining and treating college women's eating disorders are discussed.

Feeding and Eating Disorders↗

PubMed2006

Association of catecholamine-O-methyltransferase and 5-HTTLPR genotype with eating disorder-related behavior and attitudes in females with eating disorders.

OBJECTIVE: There is growing evidence, that genetic variants contribute to the pathogenesis of anorexia nervosa and bulimia nervosa. Genetic studies have revealed candidate genes, but no satisfactory associations with the disorders have been found so far. The aim of the present study was to evaluate, whether behavioral and attitudinal traits of the disorders can serve as phenotypes with a possible association with two common functional polymorphisms of the monoaminergic pathways. METHOD: Forty-five female in-patients of a specialized hospital for eating disorders were included into the study. Eating disorder symptomatology was assessed using the Eating Disorder Inventory-2. The functional catecholamine-O-methyltransferase (COMT) 158 Val-->Met polymorphism and the deletion/insertion polymorphism of the serotonin transporter promoter 5-HTTLPR were determined. RESULTS: Carriers of at least one Met-allele of the COMT gene had significantly higher total scores of the Eating Disorder Inventory-2, as well as significantly higher scores on the subscales bulimia, ineffectiveness, interoceptive awareness, maturity fears and impulse regulation. Carriers of the deletion of the 5-HTTLPR had significantly higher scores on the subscales drive for thinness and body dissatisfaction. CONCLUSION: We found associations between the COMT and the 5-HTTLPR polymorphisms and specific clinical, behavioral and attitudinal traits of eating disorders. These polymorphisms may predispose their carriers to exhibit certain symptoms of eating disorders or confer a general risk for more severe forms of these disorders.

Adolescent↗