Bias in binge eating disorder: how representative are recruited clinic samples?
ABSTRACT The aim of this study was to investigate sampling bias as it affects recruited clinic samples of binge eating disorder (BED). Demographic and clinical characteristics of a recruited clinic sample were compared with a community sample. The 2 groups met the same operational definition of BED and were assessed using the same primarily interview-based methods. Ethnicity, severity of binge eating, and social maladjustment were found to increase treatment seeking among participants with BED rather than levels of psychiatric distress or comorbidity. These findings suggest that previous studies using recruited clinic samples have not biased estimates of psychiatric comorbidity in BED.
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ABSTRACT: Although community-based studies suggest equivalent levels of physical and psychological impairment by binge eating disorder (BED) in men and women, men with BED are still underrepresented in clinical studies. This study aimed to provide a comprehensive analysis of sex differences in biopsychosocial correlates of treatment-seeking obese patients with BED in primary care. One hundred-ninety obese adults (26% men) were recruited in primary care settings for a treatment study for obesity and BED. Very few significant sex differences were found in the developmental history and in current levels of eating disorder features, as well as psychosocial factors. Women reported significantly earlier age at onset of overweight and dieting and greater frequency of dieting. Men reported more frequent strenuous exercise. Men were more likely than women to meet criteria for metabolic syndrome; men were more likely to show clinically elevated levels of triglycerides, blood pressure, and fasting glucose levels. Despite few sex differences in behavioral and psychosocial factors, metabolic problems associated with obesity were more common among treatment-seeking obese men with BED than women. The findings highlight the importance of including men in clinical studies of BED and active screening of BED in obese men at primary care settings.General hospital psychiatry 08/2013; · 2.67 Impact Factor
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ABSTRACT: Menopausal transition has been associated with emergence of metabolic abnormalities, which may increase risk for chronic medical conditions in women. This study compared metabolic function between premenopausal women (n = 152), postmenopausal women (n = 88), and men (n = 98) recruited for treatment studies for obesity co-occurring with binge eating disorder (BED), a high risk population for developing metabolic syndrome (MetS). Postmenopausal women were more likely than premenopausal women to show elevated total cholesterol (OR = 2.75; 95% CI = 1.56-4.80) and poor glycemic control (OR = 2.92; 95% CI = 1.32-6.33), but were more likely to have lower HDL levels (OR = 0.36; 95% CI = 0.19-0.68). These became non-significant after adjusting for age. Both pre- and postmenopausal women were less likely than age-matched men to show elevated levels of triglycerides (OR = 0.27; 95% CI = 0.13-0.53 [postmenopausal], OR = 0.29; 95% CI = 0.16-0.53 [premenopausal]), blood pressure (OR = 0.48; 95% CI = 0.25-0.91 [postmenopausal], OR = 0.40; 95% CI = 0.23-0.69 [premenopausal]), and less likely to have MetS (OR = 0.41; 95% CI = 0.21-0.78 [postmenopausal], OR = 0.46; 95% CI = 0.27-0.79 [premenopausal]). Premenopausal women were also less likely to have elevated fasting glucose level (OR = 0.50; 95% CI = 0.26-0.97) than age-matched men. Among obese women with BED, aging may have a more profound impact on metabolic abnormalities than menopause, suggesting the importance of early intervention of obesity and symptoms of BED. Active monitoring of metabolic function in obese men with BED may also be critical.Eating Behaviors 04/2014; · 1.58 Impact Factor