Eating and weight disorders: EWD

Publications in this journal

• Article: Mental disorders in patients with metabolic syndrome. The key role of central obesity.

  B Carpiniello, F Pinna, F Velluzzi, A Loviselli
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  ABSTRACT: Background: The Authors sought to evaluate current prevalence of mental disorders in patients affected by metabolic syndrome compared with patients affected by central obesity alone. Methods: 186 (63.5%) patients affected by central obesity and 107 (36.5%) affected by metabolic syndrome according to ICF criteria were interviewed by means of SCID I. Results: Axis I current prevalence was respectively 45.7% and 44.9% among patients with central obesity and patients with metabolic syndrome, differences which were not significant. No statistically significant differences were found between groups as far as each single axis I diagnostic category were considered. Moreover, current prevalence of any axis I, anxiety and mood disorders were independent of the number of components of metabolic syndrome. Conclusion: metabolic syndrome is associated to an higher risk for current mental disorders, which seems to be mainly due to the strong association of central obesity to psychopathology.
  Eating and weight disorders: EWD 01/2013;
• Article: Impulsivity and negative mood in adolescents with loss of control eating and ADHD symptoms: An experimental study

  Hartmann AS, Rief W, Hilbert A
  Eating and weight disorders: EWD 01/2013; 18(1):53.
• Article: Weight loss and clinical characteristics of young adults patients seeking treatment at medical centers: Data from the QUOVADIS Study.

  S Calugi, R Dalle Grave, A Compare, E Dall'aglio, M L Petroni, G Marchesini
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  ABSTRACT: To compare clinical characteristics, attrition, weight loss, and psychological changes of obese young adults and obese adults seeking treatment. 1530 individuals seeking treatment in 18 Italian medical centers were evaluated. 382 cases (25%) were classified as young adults (age≤35 years), 1148 (75%) as adults (>35 years). Psychological distress, binge eating, body uneasiness, and attitude towards eating were evaluated, at baseline and after a 12-month weight-loss program, together with BMI changes. Weight-loss expectations and primary motivation for seeking treatment were also recorded. At baseline, young adults reported significantly higher BMI at age 20, weight loss expectations and body uneasiness scores than adults. A significantly higher percentage of young adults also reported improving appearance as primary reason for seeking treatment. The attrition rate was significantly larger in young adults. Among completers, the mean percent weight loss at 12 months and improvement of psychosocial variables were significantly higher in young adults than in adults. By intention to treat, BMI changes were no longer significant between groups. Obese young adults lose more weight and considerably improve psychological distress, but show a higher attrition rate after 12 months of continuous care in a real world medical setting.
  Eating and weight disorders: EWD 12/2012; 17(4):e314-9.
• Article: Helplessness, mastery and the development of eating disorders: Exploring the links between vulnerability and precipitating factors.

  N A Troop
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  ABSTRACT: Helplessness and mastery in childhood and in response to the events that trigger onset are implicated in the development of eating disorders. However, no studies have yet explored how these are linked and whether the effects are additive or mediated. Semi-structured interviews (Childhood Experience of Care and Abuse; Life Events and Difficulties Schedule; Coping Strategies Interview) were used to assess helplessness and mastery in childhood and in response to a provoking agent in 15 eating disordered and 19 non-eating disordered women. Helplessness and mastery in childhood were related to helplessness and mastery in response to the events and difficulties that triggered onset of the eating disorder. However, only the presence of helplessness and the lack of mastery in response to this provoking agent predicted onset. Helplessness and mastery are vulnerability and protective factors but only in those women who develop an eating disorder in the context of later life events. It is suggested that helplessness and mastery in childhood act via their influence on the adequacy of coping in response to later life events.
  Eating and weight disorders: EWD 12/2012; 17(4):e274-81.
• Article: Predictors of dropout from in-patient treatment of eating disorders: An italian experience.

  L Pingani, S Catellani, F Arnone, E De Bernardis, V Vinci, G Ziosi, G Turrini, M Rigatelli, S Ferrari
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  ABSTRACT: The aim of the study was to examine possible risk factors for dropout from in-patient treatment for eating disorders (ED). The present study consisted of a retrospective analysis of clinical and non-clinical available information about 186 patients suffering from ED consecutively admitted into the Villa Maria Luigia Private Hospital (Parma, Italy) in a three-year period (01/01/2006 - 31/12/2009). Sociodemographics, clinical history and current features, and results to the following psychometric instruments were analysed: Eating Disorder Questionnaire (EDQ), Predisposing, On-set and Maintaining risk factors list for Eating Disorders, Eating Disorders Inventory-II, Body Uneasiness Test and SCL-90. Of the 186 patients, 46 (24.7%) voluntarily left the treatment program prematurely. Predictive factors included poor educational and professional achievements, parents' divorcing, parents' history of substance abuse and difficulties in interpersonal relationships. Dropout is a multifactorial phenomenon with deep clinical consequences: the recognition of possible risk factors may support the choice of specific therapeutic strategies to improve the treatment of ED and its outcomes.
  Eating and weight disorders: EWD 12/2012; 17(4):e290-7.
• Article: Gender differences, personality and eating behaviors in non-clinical adolescents.

  F Cuzzocrea, R Larcan, C Lanzarone
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  ABSTRACT: Few studies have focused on the relationship between personality trait and eating behaviors in a normal sample of adolescents. The purpose of this research was to examine differences between male and female non-clinical adolescents in eating behaviors, personality traits and state and trait anxiety and to verify the relationship between personality traits, anxiety and eating behaviors in males and females. 592 individuals (324 male and 267 females) were selected. Participants were asked to fill: Eating Disorder Inventory-2 (EDI-2), State-Training Anxiety Inventory (STAI - Forma Y) and Eysenck Personality Questionnaire - Revised (EPQ-R). The results highlighted specific differences in eating behaviors and in personality traits between genders. No statistical differences in anxiety were found. Our results underline the importance of focussing on anxiety levels for girls, while, for boys, on personality traits such as neuroticism and psychoticism. It was confirmed the opinion that, to prevent eating disorders, not only is it necessary to carry out a campaign based on proper nutrition, but also to investigate thoroughly aspects of personality that may be predictive of these disorders.
  Eating and weight disorders: EWD 12/2012; 17(4):e282-9.
• Article: Eating disorder (ED) detection through personality traits and self-concept.

  Antonio José Sánchez Guarnido, Francisco Javier Herruzo Cabrera, María José Pino Osuna
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  ABSTRACT: The current scientific evidence suggests that certain dimensions of the personality and self-concept act as risk factors of ED. However, there is little investigation that explores the different elements involved in both groups of variables together and in an exhaustive way. Our aim is to be able to discriminate between individuals diagnosed with ED and free controls of symptoms according to these personality traits and self-concept. To accomplish our objective, the Inventory of Eating Disorders 2 (EDI-2), Inventory of Personality NEO Revised (NEO-PI-R) and Self- Concept Form-5 (AF-5) were administrated to a sample composed of 69 cases of ED and 89 controls and an analysis of logistic regression was done. The pattern obtained could correctly classify 96.2% of the people diagnosed with ED and, consistent with the previous research, it should work in the same way to detect people at risk of developing ED in the future.
  Eating and weight disorders: EWD 11/2012;
• Article: Triiodothyronine (T3) and metabolic rate in adolescents with eating disorders: is there a correlation?

  Diana L Aschettino-Manevitz, Rollyn M Ornstein, Wendy Meyer Sterling, Nina Kohn, Martin Fisher
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  ABSTRACT: Purpose: To examine the correlation between T3 and resting energy expenditure(REE) in adolescent patients with eating disorders (ED) to assess whether T3 can be used to predict metabolic rate suppression and recovery. Methods: A retrospective chart review was performed on patients with ED (Anorexia Nervosa [AN], Bulimia Nervosa [BN], and Eating Disorder NOS [EDNOS]), aged 11-22 years, who had T3 and REE measured within 1 month (n=38 AN, 32 BN/EDNOS). REE was measured by indirect calorimetry (IC) and represented as the percentage of expected REE (%EREE) predicted by the Harris-Benedict equation. Pearson correlation coefficients were calculated to examine the relationship between T3 and %EREE and how each correlates with anthropometric data, laboratory values, and diagnosis. Results: T3 was significantly correlated with %EREE in the AN group but not in the total population or BN/EDNOS group. In the total study population, T3 alone correlated significantly with weight, Body Mass Index (BMI), BMI percentile, %Ideal Body Weight (IBW), %Maximum Weight Lost (MWL), LH, and estradiol. In the AN group, T3 and %EREE both correlated with BMI, BMI percentile, LH, and estradiol; however, only T3 correlated with %IBW and %MWL. In the BN/EDNOS group, T3 correlated with BMI, BMI percentile, %IBW, and estradiol while %EREE correlated with none. Conclusion: In patients with AN, T3 correlated significantly with markers of malnutrition and %EREE and may serve as a surrogate measure when IC is unavailable. Following T3 during treatment of AN may assist clinicians in assessing metabolic suppression and recovery and help guide caloric prescriptions and goal weights.
  Eating and weight disorders: EWD 11/2012;
• Article: Body composition in subjects with anorexia nervosa: bioelectrical impedance analysis and dual-energy X-ray absorptiometry.

  Guglielmo Bonaccorsi, Andrea Bassetti, Sara Chiari, Paolo Dirindelli, Chiara Lorini, Chiara Menicalli, Francesca Santomauro, Maria Grazia Martinetti
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  ABSTRACT: Objective: To evaluate the applicability and validity of bioelectrical impedance analysis (BIA) compared with dual-energy X-ray absorptiometry (DXA) in a population of girls with restrictive anorexia nervosa (AN). Methods: A total of 30 girls (11-19 years old) with AN were enrolled. DXA and BIA (BIA software and the Deurenberg equations) were used to estimate the body composition. The correlation between the methods was assessed by Pearson's correlation coefficient and the Bland- Altman method. Results: The mean FFM estimates were 33.2 kg (BIA software), 32.8 kg (BIA, Deurenberg equation) and 33.1 kg (DXA). The mean FM values were 5.6 kg (BIA software), 6.2 kg (BIA, Deurenberg equation) and 6.4 kg (DXA). There was a high correlation between the FFM values estimated with the two methods (BIA software vs. DXA r = 0.917, p <0.001; Deurenberg equation vs. DXA r = 0.931, p <0.001). For the FFM, the limits of agreement were equal to ± 3.34 kg for the BIA software and ± 2.96 kg for the Deurenberg equation. For the FM, the limits of agreement were equal to ± 4.60 kg for the BIA software and ± 3.82 kg for the Deurenberg equation. Conclusion: The results show a good correlation between DXA and BIA. BIA seems to be a valid alternative for epidemiological and clinical evaluations.
  Eating and weight disorders: EWD 11/2012;
• Article: Skipping breakfast: Morningness-eveningness preference is differentially related to state and trait food cravings.

  Adrian Meule, Karolin Roeser, Christoph Randler, Andrea Kübler
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  ABSTRACT: Eveningness preference is associated with unhealthy eating behaviors. We measured state and trait food cravings in chronotypes in the morning and in the evening. Less Evening (E)- than Morning (M)-types reported to have had breakfast. Accordingly, hours that had elapsed since the last meal were higher in E- than M-types in the morning, but did not differ between groups in the evening. E-types reported higher anticipation of positive reinforcement that may result from eating than M-types in the morning, but both had the same hunger levels. On a trait level, M-types reported more feelings of guilt for giving into cravings compared to E- types. Results suggest that E-types skip breakfast more often than M-types, but this eating pattern does not inevitably lead to more food cravings in the evening or more pronounced habitual cravings. Furthermore, E-types did not experience more hunger in the morning although they had not been eating for a longer time period. Results support findings about a different lifestyle in E-types compared to M-types.
  Eating and weight disorders: EWD 11/2012;
• Article: Anorexia nervosa in a Thai adolescent.

  R S Areemit, N Patjanasoontorn
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  ABSTRACT: In Thailand, anorexia nervosa (AN) has rarely been reported. We report a 13- year-old female adolescent with AN restrictive type, the first from Thailand to meet all Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition - Text Revision (DSM IVTR) criteria for AN. The emergence of a patient with AN in Khon Kaen, a province from the region with the lowest gross domestic product, accentuates the existence of eating disorders in adolescents beyond Thailand capital. Future studies considering sociocultural issues on normal eating attitudes, eating behaviors and body image in Thailand should be conducted.
  Eating and weight disorders: EWD 09/2012; 17(3):e207-9.
• Article: Clinical outcomes of a novel, family-centered partial hospitalization program for young patients with eating disorders.

  R M Ornstein, S E Lane-Loney, C S Hollenbeak
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  ABSTRACT: Eating disorders (ED) in children and younger adolescents are becoming more evident, but there is a small evidence base for their management in this population. We hypothesized that a new family-centered partial hospital program for young patients would be effective in promoting weight gain, as well as improvement in psychiatric symptoms. A retrospective chart review of 56 patients treated in the program between August 2008 and November 2009 was performed. Historical data, anthropometric variables and scores from psychological instruments [Children's Eating Attitudes Test (ChEAT), Children's Depression Inventory (CDI), and Revised Children's Manifest Anxiety Scale (RCMAS)] were collected on admission and at discharge. After exclusion, 30 patients were available for statistical analysis, using paired t-tests. The primary outcome variables were improvement in weight and change in total ChEAT score. Secondary outcomes included improvements in the CDI and RCMAS scores. Multivariate analysis included linear regression models that controlled for patient-specific fixed effects. The cohort was 87% female with a mean age of 12.8±2 years; 60% were diagnosed with ED not otherwise specified. Two-thirds had a co-morbid depressive and/or anxiety disorder. Change in weight was significant (p<0.0001), as were improvements on total ChEAT (p<0.0001), CDI (p=0.0002), and RCMAS (p<0.0001) scores. No historical factors were correlated with improvement, nor was use of psychotropic medications. Length of stay in weeks significantly predicted greater weight gain (p=0.004, R2=0.26). Patients treated in a family-centered partial hospital program had significant improvements in weight and psychological parameters. This approach holds significant promise for the management of young ED patients.
  Eating and weight disorders: EWD 09/2012; 17(3):e170-7.
• Article: Classical Stroop effect in bulimia nervosa.

  S Guillaume, F Van den Eynde, N Samarawickrema, H Broadbent, E Goodman-Smith, U Schmidt
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  ABSTRACT: Bulimia nervosa (BN) is a distressing condition. Its pathogenesis is not fully understood. Neurocognitive functioning, and particularly inhibitory control, is a potential biomarker that may improve our understanding of BN. A few small-scale studies have used the classical Stroop Colour Word Test (SCWT) in BN with contradictory findings. We examined SCWT performance in a large sample of people with BN (N=72), eating disorder not otherwise specified - bulimic type (N=43) and healthy controls (N=50). The results found no difference between groups on Stroop interference effect. These findings question the utility of the classical SCWT as an assessment tool in examining executive functioning in BN.
  Eating and weight disorders: EWD 09/2012; 17(3):e203-6.
• Article: Gender differences in binge eating and behavioral correlates among college students.

  S Kelly-Weeder, K M Jennings, B E Wolfe
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  ABSTRACT: The purpose of this study was to investigate gender differences in binge eating and associated behavioral correlates in college students. A webbased survey was conducted with 2073 students (mean age 19.8 yr; range 18-23 yr). Multiple logistic regression was used to calculate odds ratios and 95% confidence intervals for the factors associated with binge eating. Twenty-nine percent of students reported recent bingeing. Factors associated with binge eating included being female, having a higher body mass index, current tobacco use, and exercising to lose weight. Women were more likely to binge eat (73.8%; χ2 =32.3; p≤0.001), report loss of control (45%; χ2=16.3; p≤0.001), self induced vomiting (20.7%; χ2=15.9; p≤0.001), and laxative use (6.7%; χ2=8.93; p≤0.001). Results generated from this study suggest that gender-disparate behaviors are potential targets for future tailored interventions.
  Eating and weight disorders: EWD 09/2012; 17(3):e200-2.
• Article: Lifetime and recent DSM and ICD psychiatric comorbidity of inpatients engaging in different eating disorder behaviours.

  A von Lojewski, C Boyd, S Abraham, J Russell
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  ABSTRACT: Previous studies investigating psychiatric comorbidity in eating disorder (ED) patients compared groups according to ED diagnoses. The current paper compared groups according to ED behaviours: self-induced vomiting, objective binge eating, excessive exercising, and to body mass index (BMI, kg/m2) for selected psychiatric comorbidity using two systems: Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) and International Classification of Diseases - Tenth Revision (ICD-10) diagnoses. Two hundred and twenty-six patients admitted for treatment in a specialised Eating Disorders Unit completed the Composite International Diagnostic Interview (CIDI). Lifetime and recent (12 months) psychiatric diagnoses were produced according to DSM-IV and ICD-10. Associations between presence of ED behaviours or BMI and psychiatric comorbidity were investigated. Eighty-eight percent of patients had a lifetime history (72% recent history) of at least one comorbid diagnosis (regardless of diagnostic system). Agreement between the systems was high for mood (affective) disorders and moderate for anxiety/somatoform disorders. Significantly more patients who vomit had lifetime and recent mood (affective) disorders (DSM-IV and ICD-10). Significantly more 'vomiters' had recent anxiety disorders (DSM-IV) and neurotic, stress-related and somatoform disorders (ICD-10) including post-traumatic stress disorder (PTSD; DSM-IV and ICD-10). More patients with BMI >17.5 kg/m2 had lifetime and recent mood (affective) disorders and lifetime PTSD (DSM-IV and ICD-10). The results for 'excessive exercisers' varied and appeared inconsistent. There were no differences in any disorders for objective binge eaters. Patients who induce vomiting have more psychiatric comorbidity than 'non-vomiters', both lifetime and recent, and may benefit from diagnostic recognition as a separate group, for example 'vomiting' or 'purging' ED, who can then receive specialist treatment for their comorbidity and associated problems.
  Eating and weight disorders: EWD 09/2012; 17(3):e185-93.
• Article: Perceptions of underweight images: Are women with anorexia nervosa perceived as attractive and healthy?

  B L Whisenhunt, D L Drab-Hudson, L R Stanek, A J Dock, B J Allen, R C Vincent, C Levesque-Bristol
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  ABSTRACT: The current study examined the impact of receiving information about a woman's eating disorder status on perceptions of the woman's health and attractiveness. A total of 99 females and 84 males viewed a photo of a model who had disclosed her diagnosis of anorexia nervosa. Participants were randomly divided into three groups: model (M) group (those who were informed that the photo showed a model), eating disorders (ED) group (those who were informed that the photo showed a woman with an eating disorder), and no description control (C) group. Male and female participants in the ED group rated the woman in the photo as less healthy than did participants in the M and C groups. However, there were no differences between groups for ratings of attractiveness or the participants' desire to achieve a similar look (for females). Additionally, male participants rated the photo as less attractive than female participants had predicted. Finally, internalization of the thin ideal was a significant predictor of ratings of health and attractiveness of the woman in the photo.
  Eating and weight disorders: EWD 09/2012; 17(3):e178-84.
• Article: Tumour necrosis factor alpha and oxidative stress as maintaining factors in the evolution of anorexia nervosa.

  E Agnello, G Malfi, A M Costantino, P Massarenti, M Pugliese, N Fortunati, M G Catalano, A Palmo
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  ABSTRACT: Aim of the study was to evaluate tumour necrosis factor α (TNF- α) axis and oxidative status in patients with anorexia nervosa (AN) seeking a possible correlation with both nutritional status and evolution of the disease. Thirty-nine consecutive women with AN and an age-matched healthy control group were studied. Patients were 26±9 yr, with a body mass index (BMI) of 13.9±2 kg/m2. TNF-α, its receptors TNF-R55 and TNF-R75, and oxidative status markers (selenium, ascorbic/ dehydroascorbic acid, retinol, α-tocopherol, selenium-dependent gluthatione peroxidase, reduced/oxidated gluthatione) were measured. A correlation with both nutritional indexes (body weight, BMI, albumin, prealbumin, transferrin, lymphocyte count) and disease duration was investigated. Pearson's correlation and unpaired Student's t-test were used to compare patients and controls. TNF-α and oxidative status markers were significantly higher in patients than controls and TNF-α was directly related to dehydroascorbic acid (p<0.05). Both TNF-R55 and TNF-R75 were higher in patients with duration of disease longer than one year as compared to controls and patients with shorter duration. Receptors inversely correlated with BMI (p<0.05 and p<0.01) and directly with disease duration (p<0.05). Inverse correlation between disease duration and BMI was present (p<0.01). The study showed activation of TNF-α axis and oxidative stress in AN patients, as well as correlation between the two systems. Due to the correlation between TNF receptors and both BMI and disease duration, a possible role of pro-inflammatory cytokines in the evolution of the eating disorder is suggested.
  Eating and weight disorders: EWD 09/2012; 17(3):e194-9.