Recorded food intake of obese women with binge eating disorder before and after weight loss. Int J Eat Disord

Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD 20892.
International Journal of Eating Disorders (Impact Factor: 3.13). 04/1994; 15(2):135-50. DOI: 10.1002/1098-108X(199403)15:23.0.CO;2-I
Source: PubMed


Because binge eating in obese individuals has been postulated to be a reaction to dietary restriction, we examined the recorded food intake of 17 obese women with and 16 obese women without binge eating disorder (BED) during 1-week periods before and 3 months after a very low calorie diet program in order to determine the effects of dietary restriction on binge eating frequency and severity. Before weight loss, rather than reporting severe caloric restriction, women with BED reported greater average energy intake than nonbinge eaters on both a total (2707 vs. 1869 k cal/day, p < .01) and weight-adjusted (25.1 vs. 18.1 kcal/kg, p < .01) basis, with both higher intake on nonbinge days and an increased frequency of binge days. After weight loss, there was no significant difference in energy intake, on either a total or weight-adjusted basis, between subjects with and without BED. Although average daily energy intake fell for both groups after weight loss, only subjects with BED reported significantly decreased energy intake when adjusted for change in body weight. This resulted from decreased intake on nonbinge days and a decreased frequency of binge days. Before weight loss, subjects with BED reported an average energy intake equivalent to 94% of their predicted energy expenditure. Whereas subjects without BED reported intake only 64% of predicted (p = .002). After weight loss, there was no significant difference between subjects with and without BED in the percentage of predicted energy expenditure reported as intake (64% vs. 58%). Restraint was similar in both groups before weight loss, but those with BED reported greater hunger and disinhibition. After weight loss treatment, restraint increased significantly, whereas disinhibition and hunger remained elevated in subjects with BED. Disinhibition, rather than restraint, appears to be a major contributor to the disordered eating of these individuals. Unlike normal-weight women with bulimia nervosa, dietary restriction does not appear to worsen symptoms of binge eating in obese women with BED. Over the short term, subjects with BED may respond to a standard weight loss treatment program with improvements in binge eating behaviors.

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    • "Although these findings are promising, it is still unclear how this combination therapy affects eating behaviors, and how these behavioral changes enhance weight loss. Recent evidence suggests that weight loss in obese individuals is attributed to an increase in cognitive restraint [3-5], reduced disinhibition, lower hunger levels [4,5] and decreased consumption of dietary fat [6]. In view of these findings, key questions that have yet to be addressed in this field include: Are obese individuals able to exercise on the fast day? "
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    ABSTRACT: Alternate day fasting combined with exercise is effective for weight loss. The aim of this study was to examine the behavioral adaptations that occur when ADF is combined with exercise, and to determine how these changes affect weight loss. Obese subjects (n = 64) were randomized to 1 of 4 groups: 1) combination (ADF + endurance exercise), 2) ADF, 3) exercise, or 4) control, for 12 weeks. Body weight decreased (P < 0.05) in the combination group (6 +/- 4 kg), ADF (3 +/- 1 kg), exercise group (1 +/- 0 kg), with no change in the control group (0 +/- 0 kg). When given the choice, subjects chose to exercise the same amount (P = 0.790) on the fast days (48 +/- 2%) as feed days (52 +/- 2%). Percent of exercise sessions performed on fast day mornings (20 +/- 6%) did not differ (P = 0.453) from fast day afternoons (28 +/- 5%). Likeliness to cheat on the fast day was not higher if the subject exercised in the afternoon (17 +/- 7%) versus the morning (10 +/- 5%). Hunger decreased (P < 0.05) while satisfaction and fullness increased (P < 0.05) post-treatment in the ADF group only. Restrained eating increased (P < 0.05) and uncontrolled eating decreased (P < 0.05) in the combination and ADF groups. These findings suggest that endurance exercise is an excellent adjunct therapy to ADF, as it leads to positive behavioral changes that may contribute to long-term steady weight loss.
    Full-text · Article · Nov 2013 · Journal of the International Society of Sports Nutrition
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    • "In BED, the ability to make advantageous decisions may be especially important in periods preceding binge episodes. For example, after a period of restrained eating (Howard & Porzelius, 1999; Masheb & Grilo, 2000; Raymond et al., 2003; Rossiter et al., 1992; Yanovski & Sebring, 1994), the capacity to circumvent a binge attack may be limited due to physiological drives (Cowen & Smith, 1999). However, to adopt a regular eating schedule with a sufficient amount of food is much more reliant on conscious decisions. "
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    ABSTRACT: Even though eating is frequently driven by overindulgence and reward rather than by energy balance, few studies so far have analyzed decision-making processes and disturbances in feedback processing in women with binge eating disorder (BED). In an experimental study, 17 women with BED (DSM-IV) and 18 overweight healthy controls (HC) were compared in the game of dice task (GDT). This task assesses decision-making under risk with explicit rules for gains and losses. Additionally, differences in dispositional activation of the behavior inhibition and behavior approach system as well as cognitive flexibility were measured. Main results revealed that women with BED make risky decisions significantly more often than HC. Moreover, they show impaired capacities to advantageously utilize feedback processing. Even though these deficits were not related to disease-specific variables, they may be important for the daily decision-making behavior of women with BED, thus being relevant as a maintenance factor for the disorder.
    Full-text · Article · Sep 2009 · Appetite
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    • "Together with disinhibitions association with body size, it is possible that the tendency toward disinhibition might be of significance during periods of weight gain [77] but may not influence daily intake during periods of weight stability. In addition, disinhibition appears to be associated with bulimia nervosa [35] and binge-eating disorders [44] [45], especially in obese women [37] [46]. This suggests that the shared (familial) environment has a significant and lasting effect on the individual's dietary disinhibition and that this may have major consequences for the development of obesity and/or an eating disorder. "
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    ABSTRACT: Dietary restraint, disinhibition, and perceived hunger have been shown to affect food intake and body weight and are thought to be risk factors for eating disorders, but little is known about their origins. We investigated the influence of heredity, shared (familial) environment, and individual environment on dietary restraint disinhibition, perceived hunger and their relation to body size and food intake. Scores on the Three Factor Eating Questionnaire and the Restraint Scale in addition to height, weight, body mass index, and 7-d diary reported nutrient intakes were obtained from 39 identical, 60 fraternal same-sex, and 50 fraternal opposite-sex adult twin pairs who were living independently. Linear structural modeling was applied to investigate the nature and degree of genetic and environmental influences. Analysis showed significant genetic and individual environmental, but not shared (familial) environmental, influences on cognitive restraint, perceived hunger, and Restraint Scale scores, with genes accounting for 44%, 24%, and 58% of the variance, respectively. In contrast, disinhibition was found to be significantly influenced by the shared (familial) environment, accounting for 40% of the variance. Further analysis showed that cognitive restraint and perceived hunger heritabilities could not be accounted for by significant heritabilities of body weight, height, or body mass index. In contrast, the heritability of Restraint Scale scores was found to be related to body size. Cognitive restraint was negatively correlated with nutrient intake, and differences in cognitive restraint were found to be related to differences in the body sizes of identical twin pairs. Dietary restraint appears to be another component in a package of genetically determined physiologic, sociocultural, and psychological processes that regulate energy balance, whereas dietary disinhibition may be the intermediary between upbringing and the development of overweight and/or eating disorders.
    Full-text · Article · May 2005 · Nutrition
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