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Co-Occurrence of Binge Eating Disorder With Psychiatric and Medical Disorders
Abstract
Prior studies suggest that certain psychiatric and medical disorders co-occur with binge eating disorder (BED). However, there has been no large, community-based study with diagnoses made by clinician interviewers. We used data from that type of study to assess the co-occurrence of various psychiatric and medical disorders with DSM-IV BED and with subthreshold BED.
From October 2002 to July 2004, we interviewed 150 probands with BED, 150 probands without BED, and 888 of their first-degree relatives (135 of whom had BED, and 54 of whom met specific partial criteria for BED that we defined as subthreshold BED). Study participants were interviewed using the Structured Clinical Interview for DSM-IV to assess BED and other psychiatric disorders and a supplemental structured interview to assess certain medical disorders; participants also completed a self-report questionnaire, the Bad Things Scale. For each psychiatric and medical disorder, we calculated the age- and sex-adjusted co-occurrence odds ratio: the odds of having that disorder in one's lifetime among individuals with (full or subthreshold) lifetime BED compared to individuals without lifetime BED. We also used subjects' responses to the Bad Things Scale to adjust for adversity over-reporting, a type of response bias that could result in spurious findings of co-occurrence.
Full BED co-occurred significantly with bipolar disorder, major depressive disorder, bulimia nervosa but not anorexia nervosa, most anxiety disorders, substance use disorders, body dysmorphic disorder, kleptomania, irritable bowel syndrome, and fibromyalgia. These results changed little after correcting for adversity over-reporting. Subthreshold BED co-occurred significantly with many, but not all, of the significantly co-occurring disorders for full BED.
BED and, to a lesser degree, subthreshold BED exhibit substantial lifetime co-occurrence with psychiatric and medical disorders.
... B inge eating disorder (BED) was recognized as a feeding and eating disorder diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition (DSM-5), from the American Psychiatric Association (1). BED is characterized by recurrent episodes of binge eating -eating an unusually large amount of food compared to what one would eat within a certain period under similar circumstancesassociated with a loss of self-control when eating and Binge eating disorder, frequency of depression, and systemic inflammatory state in individuals with obesity -A cross sectional study and physical comorbidities, including major depression and other psychiatric disorders (2,3), stress, impairment of social development (2), chronic pains (2,3), and diabetes mellitus (4). ...
... B inge eating disorder (BED) was recognized as a feeding and eating disorder diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders, 5 th Edition (DSM-5), from the American Psychiatric Association (1). BED is characterized by recurrent episodes of binge eating -eating an unusually large amount of food compared to what one would eat within a certain period under similar circumstancesassociated with a loss of self-control when eating and Binge eating disorder, frequency of depression, and systemic inflammatory state in individuals with obesity -A cross sectional study and physical comorbidities, including major depression and other psychiatric disorders (2,3), stress, impairment of social development (2), chronic pains (2,3), and diabetes mellitus (4). ...
... BED is highly associated with obesity (2,3,5). In a group of adults with BED, 71% had a body mass index (BMI) ≥ 30 kg/m 2 (6). ...
Introduction:
Binge eating disorder (BED) is the most prevalent eating disorder in individuals with obesity. Its association with factors that control hunger and satiety has not yet been elucidated. We evaluated whether levels of inflammatory markers, frequency of psychiatric comorbidities, and appetite-related hormones levels differ between individuals with obesity with and without BED.
Subjects and methods:
The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-5 - Clinician Version (SCID-5-CV), Binge Eating Scale, and Hospital Anxiety and Depression Scale were evaluated in 39 individuals with obesity. Plasma levels of C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), leptin, ghrelin, and glucagon-like peptide-1 (GLP-1) were measured.
Results:
Individuals of the BED group exhibited significantly higher percentages of altered eating patterns (hyperphagia, bingeing, post-dinner eating, feeling "stuffed", and emotional eating), higher depressive symptom scores and levels of leptin, CRP, and TNF-α, compared to those from the non-BED group. Logistic regression showed that BED was independently associated with depressive symptoms and CRP levels.
Conclusion:
Individuals with obesity and BED showed greater psychiatric comorbidity, worse eating patterns and worse inflammatory profile than those without BED. BED should be assessed as an indicator of clinical severity in patients with obesity.
... Unsurprisingly, various studies reported on IBS and symptoms of IBS in AN, BN and EDNOS (Abraham & Kellow, 2011;Boyd et al., 2005;Dejong et al., 2011;Guerdjikova et al., 2012;Perkins et al., 2005;Santonicola et al., 2012;Wang et al., 2014). A few studies focused on FGID symptoms in patients with BED (Cremonini et al., 2009;Crowell et al., 1994;Javaras et al., 2008;Levy et al., 2005;Santonicola et al., 2013). Nevertheless, one study found no association between BN or BED with IBS (Singh et al., 2012). ...
... In inpatients with AN and BN on admission, a moderate positive correlation of pooled GI symptoms with hypochondriasis was detected and after follow-up, pooled GI symptoms significantly improved in patients with normal values for hypochondriasis on admission compared to those with higher scores (Salvioli et al., 2013). A significant co-occurrence with disorders such as anxiety disorders, major depressive disorder, body dysmorphic disorder as well as IBS was detected for participants with BED in a community-based study compared to controls (Javaras et al., 2008). Similar but less pronounced, associations were found for subthreshold BED and IBS (Javaras et al., 2008). ...
... A significant co-occurrence with disorders such as anxiety disorders, major depressive disorder, body dysmorphic disorder as well as IBS was detected for participants with BED in a community-based study compared to controls (Javaras et al., 2008). Similar but less pronounced, associations were found for subthreshold BED and IBS (Javaras et al., 2008). After adjustment for overreporting adverse events, which was more common in BED, the odds for co-occurring disorders did not markedly decrease (Javaras et al., 2008). ...
Objectives
The prevalence of eating disorders is rising worldwide. The low body weight in anorexia nervosa as well as the increase in body mass index due to binge eating disorder are contributing to a strikingly high morbidity and mortality. In a similar pattern, the prevalence and burden of the disease of functional gastrointestinal disorders such as functional dyspepsia and irritable bowel syndrome is increasing. As gastrointestinal complaints are commonly reported by patients with eating disorders, the question arose whether there is a relationship between eating disorders and functional gastrointestinal disorders.
Methods
To address the need to better understand the interplay between eating disorders and functional gastrointestinal disorders as well as factors that might influence this connection, the data bases Medline, Web of Science and Embase were systematically searched.
Results
After removal of duplicates the search yielded 388 studies which were screened manually. As a result, 36 publications were selected for inclusion in this systematic review.
Conclusion
The occurrence of functional gastrointestinal disorders like irritable bowel syndrome and functional dyspepsia in patients with eating disorders is considerably high and often associated with psychological, hormonal and functional alterations. In the future, further research addressing the underlying mechanisms accounting for this relationship is required.
... Forty-seven articles (Angst et al., 2018;Azorin et al., 2013;Baek et al., 2011;Baek et al., 2014;Belizario et al., 2019;Berkol et al., 2016;Boulanger et al., 2018;Brietzke et al., 2011;Faravelli et al., 2006;Goffin et al., 2016;Halmi et al., 1991;Hudson et al., 2007;Ivarsson et al., 2000;Javaras et al., 2008;Jen et al., 2013;Krüger and Cooke, 1996;Lilenfeld et al., 2008;Liu et al., 2016;Loftus et al., 2020;McElroy et al., 2013;McElroy, 2002Perugi et al., 2013a;Perugi et al., 2013b;Ramacciotti et al., 2005;Schoofs et al., 2011;Seixas et al., 2012;Swanson et al., 2011;Thiebaut et al., 2019c;Toner et al., 1988;Tseng et al., 2017;Tseng et al., 2016;Welch et al., 2016;Wildes et al., 2007;Winham et al., 2014) yielding 77 comparisons ("k") were included in the present meta-analytic review. Tables 1 and its subsets outline 36 (Angst et al., 2018;Azorin et al., 2013;Baek et al., 2011;Baek et al., 2014;Belizario et al., 2019;Berkol et al., 2016;Boulanger et al., 2018;Brietzke et al., 2011;Faravelli et al., 2006;Goffin et al., 2016;Jen et al., 2013;Krüger and Cooke, 1996;Liu et al., 2016;Loftus et al., 2020;McElroy, 2013;McElroy, 2002Perugi et al., 2013a;Perugi et al., 2013b;Ramacciotti et al., 2005;Schoofs et al., 2011;Seixas et al., 2012;Wildes et al., 2007;Winham et al., 2014) (k=58) studies investigating EDs among 15,084 univocal patients with a primary diagnosis of BD. ...
... Tables 1 and its subsets outline 36 (Angst et al., 2018;Azorin et al., 2013;Baek et al., 2011;Baek et al., 2014;Belizario et al., 2019;Berkol et al., 2016;Boulanger et al., 2018;Brietzke et al., 2011;Faravelli et al., 2006;Goffin et al., 2016;Jen et al., 2013;Krüger and Cooke, 1996;Liu et al., 2016;Loftus et al., 2020;McElroy, 2013;McElroy, 2002Perugi et al., 2013a;Perugi et al., 2013b;Ramacciotti et al., 2005;Schoofs et al., 2011;Seixas et al., 2012;Wildes et al., 2007;Winham et al., 2014) (k=58) studies investigating EDs among 15,084 univocal patients with a primary diagnosis of BD. Table 2 and its subsets documents eleven studies: (Halmi et al., 1991;Hudson et al., 2007;Ivarsson et al., 2000;Javaras et al., 2008;Lilenfeld et al., 2008;Swanson et al., 2011;Thiebaut et al., 2019c;Toner et al., 1988;Tseng et al., 2017;Tseng et al., 2016;Welch et al., 2016), fetching 19 comparisons about BD among 15,146 univocal patients with a primary diagnosis of ED. ...
... Seven reports explored the prevalence and clinical features associated with BD in BED. These studies comprised five hospital-based studies, in turn including three cross-sectional (Javaras et al., 2008;Lilenfeld et al., 2008;Welch et al., 2016), one case-control (Tseng et al., 2016), and one prospective report (Thiebaut et al., 2019c). Two additional population-based studies adopted a cross-sectional design (Hudson et al., 2007;Swanson et al., 2011). ...
Background: There are scarce and discrepant data about the prevalence and correlates of co-occurring eating disorders (EDs) among people with a primary diagnosis of bipolar disorder (BD), and vice-versa, compelling a systematic review and meta-analysis on the matter.
Methods: MEDLINE/PsycINFO databases were systematically searched for original studies documenting BD⇌ED comorbidity across the lifespan, from inception up until April 20th, 2020. Random-effects meta-analysis and meta-regression analyses were conducted, accounting for multiple moderators.
Results: Thirty-six studies involved 15,084 primary BD patients. Eleven studies encompassed 15,146 people with primary EDs. Binge eating disorder (BED) occurred in 12.5% (95%C.I.=9.4-16.6%, I2=93.48%) of BDs, while 9.1% (95%C.I.=3.3-22.6%) of BEDs endorsed BD. Bulimia Nervosa (BN) occurred in 7.4% (95%C.I.=6-10%) of people with BD, whereas 6.7% (95%C.I.=12-29.2%) of subjects with BN had a diagnosis of BD. Anorexia Nervosa (AN) occurred in 3.8% (95%C.I.=2-6%) of people with BDs; 2% (95%C.I.=1-2%) of BD patients had a diagnosis of AN. Overall, BD patients with EDs had higher odds of being female vs. non-ED controls. Several moderators yielded statistically significant differences both within- and between different types of BDs and EDs.
Limitations: Scant longitudinal studies, especially across different EDs and pediatric samples. High heterogeneity despite subgroup comparisons. Limited discrimination of the quality of the evidence.
Conclusions: The rates of BD⇌ED comorbidity vary across different diagnostic groups, more than they do according to the “direction” of BD⇌ED. Further primary studies should focus on the risks, chronology, clinical impact, and management of the onset of intertwined BD⇌ED across different ages, promoting a continuum approach.
... Elkfury et al. [8] reported that emotional eating was higher in patients with FMS. A study evaluating patients with existing or previous history of binge eating disorder (BED) reported that BED coexisted with FMS [9]. According to another study, BED might facilitate the relationship between depression and obesity in obese FMS patients [10]. ...
... In our daily clinical practice, when dealing with FMS, we have encountered complaints such as the inability to restrict eating, eating too often, or not feeling satiated. Although the literature has been reported that some eating disorders may be accompanied by FMS or that FMS patients may consume less of certain foods [8][9][10][11][12][13], the data ...
Aim. To evaluate whether eating behaviors of female patients with fibromyalgia syndrome differ from those of the healthy population, what factors affect these behaviors, and whether eating behaviors are effective on patients’ life quality and functional status.
Materials and Methods. This cross-sectional and observational study included 55 female fibromyalgia patients and 55 healthy female volunteers. All participants were assessed using demographic data, body mass index (BMI), and the Three-Factor Eating Questionnaire (TFEQ) (Uncontrolled Eating, Cognitive Restraint, Emotional Eating, and Hunger Susceptibility). Fibromyalgia patients were assessed using the Visual Analogue Scale (VAS) and Fibromyalgia Impact Questionnaire (FIQ).
Results. BMI, Uncontrolled Eating, and Hunger Susceptibility scores differed significantly between fibromyalgia patients and healthy volunteers (p < 0.05). In fibromyalgia patients, the TFEQ subscores were not correlated with the FIQ (p > 0.05). There was a positive correlation between the Cognitive Restraint score and age, rest and night pain scores in fibromyalgia patients (p< 0.05). Increasing age was an independent predictor of Cognitive Restraint in fibromyalgia patients (p=0.003).
Conclusions. The proportion of overweight/obese patients, BMI, Uncontrolled Eating, and Hunger Susceptibility were significantly higher among fibromyalgia patients. Fibromyalgia patients’ eating behaviors were not associated with their quality of life and functional status. Increasing age appeared to be a predictor of Cognitive Restraint degree.
... BED more often coexists with other mental disorders [44,48] -up to 80% of patients may have one, and 50% -three or more additional diagnoses, such as anxiety disorders (65%), mood disorders (46%), post-traumatic stress disorder (26%), or abuse of psychoactive substances (23%). Furthermore, it may coexist with chronic headaches and spinal pains, insulin resistance, and type 2 diabetes, as well as metabolic syndrome [48]. ...
... BED more often coexists with other mental disorders [44,48] -up to 80% of patients may have one, and 50% -three or more additional diagnoses, such as anxiety disorders (65%), mood disorders (46%), post-traumatic stress disorder (26%), or abuse of psychoactive substances (23%). Furthermore, it may coexist with chronic headaches and spinal pains, insulin resistance, and type 2 diabetes, as well as metabolic syndrome [48]. ...
Eating disorders (ED) constitute the third most common group of chronic diseases among people aged 14-19 years after asthma and obesity, and one of their forms is binge eating disorder (BED). The purpose of the present review was to summarize new research findings on BED and overview the epidemiology, characteristics, criteria, etiopathogenesis, and treatment. Etiopathogenesis of BED is still poorly understood, and the current state of knowledge leads to the conclusion that the pathomechanism of the development and persistence of the symptoms of that disorder is very complicated - factors influencing these symptoms have a genetic, neurobiological, biochemical, cognitive, and emotional background. Treatment targeted at selected pathogenetic mechanisms - i.a., disturbance in the corticostriatal circuit, neurohormonal dysregulation or incorrect regulation of emotions - may be of help for people with binge eating disorder. Often comorbid mental, e.g., mood, anxiety and personality disorders, psychoactive substance abuse, suicidal ideation and suicide attempts, and somatic problems are particularly crucial in the context of primary care physicians and psychiatrists work and should encourage the expanding knowledge about BED and the creation of interdisciplinary therapeutic teams.
... Psychiatric symptomatology. Compared to weight-matched, non-binge eating individuals, those with BED have been found to report elevated rates of psychiatric comorbidity and distress (Bulik, Sullivan & Kendler, 2002;Javaras et al., 2008). Approximately 30% to 80% of individuals with BED meet criteria for lifetime comorbid mood or anxiety disorder (Dingemans, Visser, Paul & van Furth, 2015;Sheehan & Herman, 2015). ...
... In fact, the current investigation's sample may be better characterized as "healthy" due to these exclusionary criteria and may not adequately represent a subclinical binge eating population. Research investigating the relations between binge eating and psychological comorbidity has found elevated rates of psychiatric comorbidity and distress in this population (e.g., Javaras et al., 2008), with approximately 30% to 80% of individuals with BED meeting criteria for lifetime comorbid mood or anxiety disorder (e.g., Sheehan & Herman, 2015). Moreover, individuals with BED endorse lower scores on measures of general health and mental health-related quality of life, independent of sex, age, education, marital status, and race when compared to those without BED (Grucza et al., 2007). ...
The central aim of this study was to investigate the predictive role of perceived control in binge eating severity, mood reactivity, and possible concomitants with reduced cardiovascular function as measured by high frequency heart rate variability (HF-HRV/RSA). Participants (N = 75) included normal to overweight men and women who completed self-report measures assessing perceived control, binge eating severity, perceived stress, negative affect, and depressive symptom severity prior to a structured clinical interview and second experimental laboratory session. During this second experimental lab session, noninvasive electrical sensors were placed for physiological recordings to measure fluctuations in HF-HRV/RSA in participants randomized to a negative or neutral mood induction task. In addition to physiological data, participants completed self-report measures of mood and stress during baseline assessment, post-mood induction, and following a recovery period. Results indicated that perceived control was predictive of binge eating severity such that higher self-reported perceived control was associated with less severe binge eating symptoms. This association was significantly mediated by perceived stress and depressive symptoms, such that those with greater perceived control also experienced less perceived stress and reduced depressive symptoms, which then significantly predicted less binge eating severity. These associations remained significant across sex and history of major depressive disorder (MDD). No significant associations were observed between perceived control, binge eating severity, and mood, stress, or HF-HRV/RSA reactivity. Results from the current investigation suggest that perceived control may buffer individuals from stress and depressive symptoms and predict less severe binge eating symptoms. Importantly, perceived control is an adaptive variable that can be modified through experience (Surtees et al., 2010). In line with prior research, which suggests that perceived control may be a malleable treatment target and predictive of positive outcomes following CBT for anxiety and mood disorders (Doering et al., 2015), the current results propose that perceived control may be a universal treatment target across various binge eating populations.
... Binge-eating related psychopathology has been associated with increased risk for a variety of clinical comorbidities, not necessarily associated with overweight and obesity [1]. For instance, some reports showed bingeeating behaviors, especially binge eating disorder (BED), to be associated with increased risk of hypertension, gastrointestinal disorders and fibromyalgia [2]. In this respect, the comorbidity between type 2 diabetes mellitus (T2DM) and BED has been consistently found in prevalence studies [2,3]. ...
... For instance, some reports showed bingeeating behaviors, especially binge eating disorder (BED), to be associated with increased risk of hypertension, gastrointestinal disorders and fibromyalgia [2]. In this respect, the comorbidity between type 2 diabetes mellitus (T2DM) and BED has been consistently found in prevalence studies [2,3]. ...
Background:
Eating behavior is an important aspect related to type 2 diabetes mellitus (T2DM) treatment and may have an impact on glycemic control. Previous reports showed elevated prevalence of eating disordered behaviors, especially binge eating disorder in clinical samples of type 2 diabetes patients. However, results regarding the impact of an eating disorder on the glycemic and clinical control of T2DM is inconsistent. The purpose of this study was to assess the impact of a comorbid eating disorder on glycemic control (GC) in a group of patients with T2DM.
Methods:
Eating behaviors of 70 consecutive patients with T2DM were assessed using a Structured Clinical Interview for DSM-IV and the Binge Eating Scale. The GC was examined with fasting blood glucose (FBG) and glycated hemoglobin (A1c) levels. In addition, secondary clinical variables were assessed, including body mass index (BMI) and lipids. Chi-square and Student's T tests were used to compare clinical and psychopathological characteristics of patients with and without an ED. In order to evaluate the relationship between GC and eating disorder (ED) a linear regression analysis was performed, controlling for BMI. A significance level of 5% was adopted.
Results:
Seventy-seven percent of the sample (n = 54) were female and 50% were obese. Fourteen patients exhibited an ED, mostly binge eating disorder (BED). In a regression analysis, both FBG (beta coefficient = 47.4 (22.3); p = 0.037) and A1c (beta coefficient = 1.12 (0.57); p = 0.05) were predicted by the presence of an ED. However, the presence of an ED lost its impact on glycemic control outcomes after the addition of the BMI in the models.
Conclusions:
Eating psychopathology is frequently observed in patients with T2DM. Among individuals with T2DM, co-morbid ED is associated with a poorer glycemic control in the presence of a higher BMI. The presence of an eating disordered behavior in patients with T2DM seems to have clinical relevance in the usual care of patients with diabetes. Therefore, we recommend eating psychopathology should be routinely assessed in T2DM patients.
... We then assessed the predictive performance of our model against the hold-out group: the F1 score was 21% (Fig. 1c), the BED is epidemiologically associated with obesity, metabolic dysfunction, multiple psychiatric disorders and low overall wellbeing 4,7 . In studies in which both cases and controls are categorized as overweight or obese, the heritability of BED is higher than when body mass index (BMI) is not considered 1,2,8 . ...
Binge eating disorder (BED) is the most common eating disorder, yet its genetic architecture remains largely unknown. Studying BED is challenging because it is often comorbid with obesity, a common and highly polygenic trait, and it is underdiagnosed in biobank data sets. To address this limitation, we apply a supervised machine-learning approach (using 822 cases of individuals diagnosed with BED) to estimate the probability of each individual having BED based on electronic medical records from the Million Veteran Program. We perform a genome-wide association study of individuals of African (n = 77,574) and European (n = 285,138) ancestry while controlling for body mass index to identify three independent loci near the HFE, MCHR2 and LRP11 genes and suggest APOE as a risk gene for BED. We identify shared heritability between BED and several neuropsychiatric traits, and implicate iron metabolism in the pathophysiology of BED. Overall, our findings provide insights into the genetics underlying BED and suggest directions for future translational research.
... In 'subthreshold BED' all of the criteria for BED are met except that patients binge, on average, less than once a week or for less than 3 months. BED is significantly associated with obesity, major comorbid psychiatric disorders, numerous medical disorders [3][4][5][6][7][8][9] and significant psychosocial impairments [4,6,9]. Studies on efficacy showed that both cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT), have short-and long-term benefits for BED [11]. ...
Background
Binge eating disorder (BED), as the most prevalent eating disorder, is strongly related to obesity and other somatic and psychiatric morbidity. Despite evidence-based treatments a considerable number of BED patients fail to recover. There is preliminary evidence for the association between psychodynamic personality functioning and personality traits on treatment outcome. However, research is limited and results are still contradictory. Identifying variables associated with treatment outcome could improve treatment programs. The aim of the study was to explore whether personality functioning or personality traits are associated with Cognitive Behavioral Therapy (CBT) outcome in obese female patients with BED or subthreshold BED.
Methods
Eating disorder symptoms and clinical variables were assessed in 168 obese female patients with DSM-5 BED or subthreshold BED, referred to a 6-month outpatient CBT program in a pre-post measurement design. Personality functioning was assessed by the Developmental Profile Inventory (DPI), personality traits by the Temperament and Character Inventory (TCI). Treatment outcome was assessed by the Eating Disorder Examination-Questionnaire (EDE-Q) global score and self-reported binge eating frequency. According to the criteria of clinical significance, 140 treatment completers were categorized in four outcome groups (recovered, improved, unchanged, deteriorated).
Results
EDE-Q global scores, self-reported binge eating frequency and BMI significantly decreased during CBT, where 44.3% of patients showed clinically significant change in EDE-Q global score. Treatment outcome groups showed significant overall differences on the DPI Resistance and Dependence scales and the aggregated ‘neurotic’ scale. Significant overall differences were found between groups on TCI Harm avoidance, although post hoc t-tests were non-significant. Furthermore, multiple logistic regression analysis, controlling for mild to moderate depressive disorder and TCI harm avoidance showed that ‘neurotic’ personality functioning was a significant negative predictor of clinically significant change.
Conclusion
Maladaptive (‘neurotic’) personality functioning is significantly associated with a less favorable outcome after CBT in patients with binge eating. Moreover, ‘neurotic’ personality functioning is a predictor of clinically significant change. Assessment of personality functioning and personality traits could support indication for more specified or augmented care, tailored towards the patients’ individual strengths and vulnerabilities.
Trial registration
This study protocol was retrospectively evaluated and approved on 16-06-2022 by the Medical Ethical Review Committee (METC) of the Amsterdam Medical Centre (AMC). Reference number W22_219#22.271.
... For any patient who is undergoing an initial psychiatric evaluation, it is important to assess the patient's use of caffeine, tobacco, alcohol, cannabinoids, and other substances, as well as any misuse of prescribed or over-the-counter (OTC) medications or supplements (see Guideline II, "Substance Use Assessment," in the Practice Guidelines for the Psychiatric Evaluation of Adults; American Psychiatric Association 2016). Substance use disorders are frequently comorbid with eating disorders (Bahji et al. 2019;Harrop and Marlatt 2010;Javaras et al. 2008;Krug et al. 2008); thus, a comprehensive substance use history is essential in a patient with a potential eating disorder. Cigarette smoking (including electronic cigarettes or vaping) can be used to suppress appetite Naveed et al. 2021), and smoking can affect the rate of weight restoration during treatment (Van Wymelbeke et al. 2004). ...
... Binge eating episodes are commonly associated with medical and psychiatric conditions [1]. For instance, recurrent binge eating was found to be associated with obesity, diabetes, chronic pain, fibromyalgia, gastrointestinal problems such as irritable bowel syndrome, nutritional deficiencies, reproductive health difficulties, and depression [2][3][4][5][6][7][8][9]. Moreover, a narrative review discussing the relationship between eating disorders and sleep problems suggested that people with eating disorder behaviors exhibit a greater occurrence of disrupted sleep, in comparison to people without eating disorder behaviors [10]. ...
Background:
Sleep problems are known to compound the negative effects of other health issues, such as eating disorders and the associated behavior of binge eating. Previous studies suggested associations between binge eating and sleep problems, but the strength of the relationship is unknown.
Methods:
We conducted a systematic review with meta-analyses examining the relationship between binge eating and sleep parameters. We searched for studies in Scopus, PubMed, and PsycInfo. The quality of evidence, including risk of bias, was assessed with adaptations of the Newcastle-Ottawa Scale and the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies, depending on study design. Data was synthesized as the difference in sleep between people who did or did not have binge eating.
Results:
Thirty-one reports of studies met our eligibility criteria. Results are presented in 12 meta-analyses. In the 7 reports of studies (with 4448 participants) that assessed poor overall sleep quality, we found poorer overall sleep quality in people with binge eating compared to people without binge eating, with a standardized mean difference of 0.77 (95% confidence interval [CI] 0.61-0.92; P < 0.001), which is a large effect size. In addition, we found evidence that people with binge eating had significantly greater hypersomnia/daytime sleepiness (7 reports of studies with 4370 participants), insomnia (5 reports of studies with 12,733 participants), and difficulty falling asleep (3 reports of studies with 4089 participants) compared to people without binge eating, with moderate effect sizes (standardized mean differences of 0.57-0.66).
Conclusions:
People with binge eating exhibit poorer overall sleep quality compared to people without binge eating, and may also exhibit greater hypersomnia/daytime sleepiness, insomnia, and difficulty falling asleep. It is recommended that healthcare professionals routinely screen for poor overall sleep quality when treating people with binge eating-and address sleep difficulties when present.
... Особенности течения НПП у больных с расстройствами шизофренического спектра (РШС) часть исследователей связывают с психопатологическим процессом и отмечают высокий процент коморбидности НПП и шизофренического расстройства. Этот же факт подтверждают и зарубежные источники [6,8,9,13,14,17]. Исследования Song F. с соавт. ...
The aim of the study was to study the clinical and typological features of eating disorders in patients with schizophrenia spectrum disorders.
Materials and methods. We studied 136 patients (84 women and 52 men) with schizophrenia spectrum disorders, aged 19 to 58 years, mean age 37.6±9.8 years; the average duration of the disease was 8.6+7.6 years. Criteria for inclusion in the study: age from 18 to 60 years, the presence of disorders of the schizophrenia spectrum, in accordance with the criteria for ICD-10 (F. 20; F. 25), informed consent for participation in the study. Exclusion criteria: organic diseases of the central nervous system, endocrine pathology, severe somatic and gynecological diseases, pregnancy and lactation. The design of the study was open, comparative, non-randomized. The study of patients was carried out once before the start of therapy. Research methods: anamnestic, clinical-psychopathological, psychometric, anthropometric and clinical-statistical.
Results: Clinical and endocrine features of the majority of the studied patients were: appetite deviations, varied in nature, intensity and frequency; an increase in body weight of varying degrees, the predominance of the external type of eating disorders, including as part of a mixed type (more than 60% of cases); a high degree of expressiveness of the emotional and restrictive types; a combination of a significant severity of the emotional type with the apathetic nature of affective disorders occurring within the framework of the underlying disease; single-phase variant of the flow of restrictive type. Clinical features in the studied patients with obesity were the stability of disorders and the combination of increased appetite and daily volume of high-calorie nutrition, incorrect family culinary traditions, the prevalence of mixed or external type.
Conclusion. The management of patients with schizophrenia spectrum disorders with eating disorders should be comprehensive, together with endocrinologists, therapists, nutritionists. An integrated approach should include: observation and counseling by narrow specialists, recommendations for the normalization of lifestyle, diet, the formation of a low-calorie diet and nutrition stereotype in the patient’s family.
... 8 However, as a stimulant, lisdexamfetamine poses the potential for abuse, which may be problematic for a significant proportion of people with BED, given the elevated rate of substance use disorders in this population. 13,14 Liraglutide is a glucagon-like-peptide-1 (GLP-1) receptor agonist that is approved by the U.S. Food and Drug Administration and European Medicines Agency for chronic weight management as an adjunct to a reduced-calorie diet and increased physical activity. ...
Objective:
To assess the efficacy of liraglutide 3.0 mg, a glucagon-like peptide-1 (GLP-1) receptor agonist, for binge eating disorder (BED).
Methods:
Adults with a body mass index (BMI) ≥ 27 kg/m2 enrolled in a pilot, 17-week double-blind, randomized controlled trial of liraglutide 3.0 mg/day for BED. The primary outcome was number of objective binge episodes (OBEs)/week. Binge remission, weight change, and psychosocial variables were secondary outcomes. Mixed effect models were used for continuous variables, and generalized estimating equations were used for remission rates.
Results:
Participants (n = 27) were 44.2 ± 10.6 years; BMI = 37.9 ± 11.8 kg/m2; 63% women; and 59% White and 41% Black. At baseline, the liraglutide group (n = 13) reported 4.7 ± 0.7 OBEs/week, compared with 3.0 ± 0.7 OBEs/week for the placebo group, p = 0.07. At week 17, OBEs/week decreased by 4.0 ± 0.6 in liraglutide participants and by 2.5 ± 0.5 in placebo participants (p = 0.37, mean difference = 1.2, 95% confidence interval 1.3, 2.0). BED remission rates of 44% and 36%, respectively, did not differ. Percent weight loss was significantly greater in the liraglutide versus the placebo group (5.2 ± 1.0% vs. 0.9 ± 0.7%, p = 0.005).
Conclusion:
Participants in both groups reported reductions in OBEs, with the liraglutide group showing clinically meaningful weight loss. A pharmacy medication dispensing error was a significant limitation of this study. Further research on liraglutide and other GLP-1 agonists for BED is warranted.
... 4.1.5. Theme 5: Trauma and Adversity (79%) Expert awareness of the associations between trauma history or adversity and binge eating disorder are reflected in systematic reviews and meta-analyses collectively [19,[112][113][114][115][116][117][118][119][120][121][122][123][124][125][126][127]. These forms of trauma can include adverse childhood experiences (ACEs), adverse life experiences (ALEs), family-related non-abuse ALEs, and post-traumatic stress disorder (PTSD). ...
Background:
Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional study assessed whether there is consensus among experts in the field about environmental factors that influence adult binge eating disorder pathology.
Methods:
Fourteen expert binge eating disorder researchers, clinicians, and healthcare administrators were identified internationally based on federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Semi-structured interviews were recorded anonymously and analyzed by ≥2 investigators using reflexive thematic analysis and quantification.
Results:
Identified themes included: (1) systemic issues and systems of oppression (100%); (2) marginalized and under-represented populations (100%); (3) economic precarity and food/nutrition insecurity/scarcity (93%); (4) stigmatization and its psychological impacts (93%); (5) trauma and adversity (79%); (6) interpersonal factors (64%); (7) social messaging and social media (50%); (8) predatory food industry practices (29%); and (9) research/clinical gaps and directives (100%).
Conclusions:
Overall, experts call for policy changes around systemic factors that abet binge eating and for greater public education about who can have binge eating disorder. There is also a call to take and account for the narratives and life experiences of individuals with binge eating disorder to better inform our current understanding of the diagnosis and the environmental factors that impact it.
... BED is epidemiologically associated with obesity, metabolic dysfunction, multiple psychiatric disorders and low overall well-being 4,7 . The heritability of BED is enhanced when adjusting for its association with obesity 1,2 . ...
Binge-eating disorder (BED) is the most common eating disorder yet its genetic architecture remains largely unknown. Studying BED is challenging because it is often comorbid with obesity, a common and highly polygenic trait, and it is underdiagnosed in biobank datasets. To address this limitation, we apply a supervised machine learning approach to estimate the probability of each individual having BED based on electronic medical records from the Million Veteran Program. We perform a genome-wide association study on individuals of African ( n = 77,574) and European ( n = 285,138) ancestry while controlling for body mass index to identify three independent loci near the HFE, MCHR2 and LRP11 genes, which are reproducible across three independent cohorts. We identify genetic association between BED and several neuropsychiatric traits and implicate iron metabolism in the pathophysiology of BED. Overall, our findings provide insights into the genetics underlying BED and suggest directions for future translational research.
... The higher scores on the PHQ-8 in the binge-eating sample indicate that this population may have a higher burden of depression symptoms. This is consistent with the co-occurrence of binge-eating disorder and depression and other mental illnesses (62). The higher scores on several trait-level, baseline self-regulation measures in the smoking sample compared with the binge-eating sample could indicate that those who binge eat may have larger deficits in self-regulation on average than those who smoke. ...
Introduction:
Self-regulation has been implicated in health risk behaviors and is a target of many health behavior interventions. Despite most prior research focusing on self-regulation as an individual-level trait, we hypothesize that self-regulation is a time-varying mechanism of health and risk behavior that may be influenced by momentary contexts to a substantial degree. Because most health behaviors (e.g., eating, drinking, smoking) occur in the context of everyday activities, digital technologies may help us better understand and influence these behaviors in real time. Using a momentary self-regulation measure, the current study (which was part of a larger multi-year research project on the science of behavior change) used ecological momentary assessment (EMA) to assess if self-regulation can be engaged and manipulated on a momentary basis in naturalistic, non-laboratory settings.
Methods:
This one-arm, open-label exploratory study prospectively collected momentary data for 14 days from 104 participants who smoked regularly and 81 participants who were overweight and had binge-eating disorder. Four times per day, participants were queried about momentary self-regulation, emotional state, and social and environmental context; recent smoking and exposure to smoking cues (smoking sample only); and recent eating, binge eating, and exposure to binge-eating cues (binge-eating sample only). This study used a novel, momentary self-regulation measure comprised of four subscales: momentary perseverance, momentary sensation seeking, momentary self-judgment, and momentary mindfulness. Participants were also instructed to engage with Laddr, a mobile application that provides evidence-based health behavior change tools via an integrated platform. The association between momentary context and momentary self-regulation was explored via mixed-effects models. Exploratory assessments of whether recent Laddr use (defined as use within 12 h of momentary responses) modified the association between momentary context and momentary self-regulation were performed via mixed-effects models.
Results:
Participants (mean age 35.2; 78% female) in the smoking and binge-eating samples contributed a total of 3,233 and 3,481 momentary questionnaires, respectively. Momentary self-regulation subscales were associated with several momentary contexts, in the combined as well as smoking and binge-eating samples. For example, in the combined sample momentary perseverance was associated with location, positively associated with positive affect, and negatively associated with negative affect, stress, and tiredness. In the smoking sample, momentary perseverance was positively associated with momentary difficulty in accessing cigarettes, caffeine intake, and momentary restraint in smoking, and negatively associated with temptation and urge to smoke. In the binge-eating sample, momentary perseverance was positively associated with difficulty in accessing food and restraint in eating, and negatively associated with urge to binge eat. While recent Laddr use was not associated directly with momentary self-regulation subscales, it did modify several of the contextual associations, including challenging contexts.
Conclusions:
Overall, this study provides preliminary evidence that momentary self-regulation may vary in response to differing momentary contexts in samples from two exemplar populations with risk behaviors. In addition, the Laddr application may modify some of these relationships. These findings demonstrate the possibility of measuring momentary self-regulation in a trans-diagnostic way and assessing the effects of momentary, mobile interventions in context. Health behavior change interventions may consider measuring and targeting momentary self-regulation in addition to trait-level self-regulation to better understand and improve health risk behaviors. This work will be used to inform a later stage of research focused on assessing the transdiagnostic mediating effect of momentary self-regulation on medical regimen adherence and health outcomes.
Clinical trial registration:
ClinicalTrials.gov, Identifier: NCT03352713.
... The relative risk for BN is around 4 times greater for female relatives of affected probands (7,8). Moreover, twin studies estimated a hereditability between 56 and 74% for AN (9, 10), 47% for BN (11), and between 41 and 57% for BED (12,13). There are also numerous evidence regarding the multi-factorial nature of EDs where environmental factors, psychological and traumatic conditions as well as epigenetic mechanisms contribute to the disease etiopathogenesis (2). ...
Anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are the three most common eating disorders (EDs). Their etiopathogenesis is multifactorial where both the environmental and genetic factors contribute to the disease outcome and severity. Several polymorphisms in genes involved in the dopaminergic pathways seem to be relevant in the susceptibility to EDs, but their role has not been fully elucidated yet. In this study, we have analyzed the association between selected common polymorphisms in the DRD2 and DRD4 genes in a large cohort of Italian patients affected by AN (n = 332), BN (n = 122), and BED (n = 132) compared to healthy controls (CTRs) (n = 172). Allelic and genotypic frequencies have been also correlated with the main psychopathological and clinical comorbidities often observed in patients. Our results showed significant associations of the DRD2-rs6277 single nucleotide polymorphism (SNP) with AN and BN, of the DRD4-rs936461 SNP with BN and BED and of DRD4 120-bp tandem repeat (TR) polymorphism (SS plus LS genotypes) with BED susceptibility. Moreover, genotyping of DRD4 48-bp variable number TR (VNTR) identified the presence of ≥7R alleles as risk factors to develop each type of EDs. The study also showed that ED subjects with a history of drugs abuse were characterized by a significantly higher frequency of the DRD4 rs1800955 TT genotype and DRD4 120-bp TR short-allele. Our findings suggest that specific combinations of variants in the DRD2 and DRD4 genes are predisposing factors not only for EDs but also for some psychopathological features often coupled specifically to AN, BN, and BED. Further functional research studies are needed to better clarify the complex role of these proteins and to develop novel therapeutic compounds based on dopamine modulation.
... Порушення харчової поведінки (ПХП), а саме компульсивне переїдання (КП) та синдром нічного переїдання (СНП), належать до гіперфагічних ПХП, які можуть бути причиною ожиріння, а також викликати декомпенсацію ЦД2Т, підвищуючи рівень глікованого гемоглобіну (HbA1c), ліпопротеїдів низької щільності (ЛПНЩ) та тригліцеридів, які є провісниками кардіоваскулярних подій [2]. ...
... Elevated levels of anxiety and depression were found in patients with a co-existing eating disorder (ED) and substance use disorder (SUD) [30,31]. Courbasson R et al. [32] performed a study to evaluate the efficacy of DBT and TAU on women with both SUD and ED. ...
Background
Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy (CBT) that was earlier intended to treat only patients with borderline personality disorder (BPD), but researchers have found DBT to treat several psychological disorders, including depression.
Aim
The article aims to review the clinical shreds of evidence regarding the use of DBT to treat depression.
Methods
PubMed literature search was done by applying the year filter range, 2010 to 2021. Another filter applied was "Randomized controlled trial", so that the strength of evidence could be enhanced. The keywords used were "Dialectical Behavior Therapy" AND "Depression
Results
33 articles were found, out of which only 20 relevant articles were reviewed. DBT was found to alleviate depressive symptoms associated with different psychological disorders like bipolar disorder and BPD but the number of studies that validated the afore-mentioned were less than those studies which showed that DBT had no significant effect on the patients with depressive difficulties. The long-term effect of DBT for treating depression is under a suspect, as studies showed DBT got ineffective during the follow-ups
Conclusion
DBT shows benefits in depression but further studies are still required to validate this concretely as DBT did not show a significant effect when compared to its control counterparts. There is much need for future studies which can evaluate the long-term efficacy of DBT in depression is another challenging area because follow-up data did not favor DBT.
... but also interferes with their mental health. For example, EDs have been shown to be closely related to depression and other psychological conditions (Agh et al., 2016;Grilo, White, & Masheb, 2009;Hudson, Hiripi, Pope Jr, & Kessler, 2007;Javaras et al., 2008). In severe cases, EDs may adversely affect the patient along with other complications and lead to death (Crow et al., 2009;Mitchell, Mazzeo, Schlesinger, Brewerton, & Smith, 2012;Smink, van Hoeken, & Hoek, 2013;Yao et al., 2016). ...
Eating disorders are psychiatric disorders that have a significant negative impact on a person's physical and mental health. Emotional intelligence (EI) has been hypothesized to be negatively associated with disordered eating behaviors, however previous research on this hypothesis has shown contradictory results. Therefore, the current meta-analysis aimed at exploring the relationship between EI and disordered eating behaviors based on previous studies. Analysis of 20 studies using a three-level random-effects meta-analysis model revealed an overall negative association between EI and eating disorders, r = −0.17 (95% CI: −0.25, −0.08; p < .001), with a small effect size.
Furthermore, subsequent moderator analyses revealed that the type of emotional intelligence (trait EI versus ability EI) helped explain the heterogeneity of the previous findings, with the association between trait EI and disordered eating (r = −0.23; 95% CI: −0.33, −0.13; p < .001) being significantly greater than the association between ability EI and disordered eating (r = −0.12; 95% CI: −0.22,. -0.03; p = .010), indicating that trait EI was more closely associated with disordered eating than ability EI. Overall, this study confirms the relationship between EI and disordered eating behaviors, suggesting that individuals with higher EI are less likely to have disordered eating behaviors.
... These behaviours involve consuming abnormally large amounts of food in a discrete period of time, during which one feels unable to stop [2]. Episodes are succeeded by marked emotional distress [2], while increased frequency is linked to impaired social functioning, anxiety and depression [3], and heightened risk for metabolic syndrome [4]. ...
Plain English Summary Binge eating tendencies have become an increasingly common phenomenon in adolescent populations. These behaviours involve consuming large amounts of food in a short period of time, during which one feels out of control and unable to stop. Episodes are often followed by marked emotional distress that can serve to perpetuate and maintain these tendencies. The current study examined a group of adolescents aged 13 to 16 over three testing periods spaced 12 to 18 months apart, to investigate whether high levels of anxiety and stress interacted to increase likelihood of binge eating tendencies in individuals over time. Results revealed that participants who experienced higher anxiety and stress than usual were more likely to score highly on binge eating tendencies measures, compared to when they experienced lower levels of anxiety and stress. Correspondingly, we recommend raising greater awareness in parents, educators, and health professionals of the link between high anxiety and stress and increased risk of binge eating tendencies, in order to facilitate better prevention, detection, and early intervention.
... This modification is due to the patients' access to adaptive emotions during treatment sessions [9]. Inappropriate eating habits are for releasing negative emotions [10] and binge eating is a way for escaping from self-awareness by focusing on excessive eating followed by purging [11]. ...
Objectives: This study aims to investigate the effect of Emotion-Focused Therapy (EFT) on depression, anxiety, and Difficulty in Emotion Regulation (DER) in women with Binge Eating Disorder (BED). Methods: This is a quasi-experimental study with pre-test/post-test/follow-up design using a control group. Study population consists of all women referred to the obesity clinics in Tehran in 2019. Of these, 40 were selected using a purposive sampling method and were randomly divided into two groups of intervention (n=20) and control (n=20). The intervention group received 10 sessions of EFT, each session for 90 minutes. Data collection tools were the Beck Anxiety Inventory (BAI), the Beck Depression Inventory II (BDI-II), Difficulties in Emotion Regulation Scale (DERS), and Binge Eating Scale (BES), which were completed before and after the intervention. Data were analyzed using descriptive statistics and repeated measure ANIVA in SPSS v. 21 software. Results: Group EFT significantly reduced the mean anxiety, depression, DER and severity of binge eating after intervention and over the 2-month follow-up period in BED women (P<0.05). Conclusion: The EFT can reduce anxiety, depression, DER and binge eating severity in BED women, and its effect remains constant after two months. It can be useful in the treatment of BED.
... One of the recent findings exposed that 67% to 79% of BED patients would also have at least one comorbid mental disorder throughout the life span. The most prevalent disorders include mood and anxiety disorders [18][19][20]. In other words, emotions of BED patients are more negative compared to common Advances in Social Science, Education and Humanities Research, volume 561 individuals. ...
... Medical and psychiatric comorbidities are commonly observed in individuals with BED. At least one core DSM-5 disorder can be found co-occurring in up to 80% of BED patients, mainly depression and anxiety disorders, although other psychiatric disorders, including bipolar disorder, borderline personality disorder, and substance abuse have also been found to be related to BED. 4,5 However, its association to general psychopathology, the presence of clinical comorbidity must not be forgotten. Higher prevalence rates of BED are found in overweight and obese individuals, 6 and indeed, the presence of psychopathology as associated to obesity seems to be more severe in the presence of BED. 7 Also, individuals with BED have an increased risk to develop type 2 diabetes, are more likely to develop nonalcoholic fatty liver disease, gastrointestinal problems, and disrupted sleep. ...
Binge eating disorder (BED) affects a significant rate of the general population causing a negative impact on their quality of life, weight, and self-esteem. Besides psychological treatments that compose the majority of the studies, pharmaceuticals have contributed to improve a host of clinical parameters, thus being an important component of the treatment. We opted to target the latest results by performing a review of the literature on the pharmacology for BED from the last 5 years. To achieve this goal, the terms: “binge eating disorder” and “treatment” were added to the PubMed database and the website clinicaltrials.gov. At least five drugs were either being tested or had already been recognized to improve BED symptoms – although only lisdexamfetamine is currently approved by the FDA to treat this condition. However, due to a better understanding of BED psychopathology in the last decade, it is notorious that improvement of eating-related symptoms is not the only desired target. Due to the significant comorbidity percentage (30%), weight loss is highly pursued, as well as the amelioration of clinical parameters which highlights the importance of having new agents combining both objectives.
... Based on physician reporting of current comorbidities, the most frequently observed comorbidities included anxiety, depression and/or major depressive disorder, obesity, and dyslipidemia. These findings are consistent with those of previously published reports indicating that patients with BED exhibit an increased frequency and risk of psychiatric [8][9][10][11] and medical comorbidities [10,31]. For example, Udo and Grilo reported that mood and anxiety disorders were among the most prevalent psychiatric comorbidities in US patients diagnosed with BED, with the prevalence of hypertension (31.2%), high cholesterol (27.2%), high triglycerides (14.5%), and diabetes (13.6%) also being relatively high [10]. ...
Purpose:
In the Canadian healthcare setting, there is limited understanding of the pathways to diagnosis and treatment for patients with binge eating disorder (BED).
Methods:
This retrospective chart review examined the clinical characteristics, diagnostic pathways, and treatment history of adult patients diagnosed with BED.
Results:
Overall, 202 charts from 57 healthcare providers (HCPs) were reviewed. Most patients were women (69%) and white (78%). Mean ± SD patient age was 37 ± 12.1 years. Comorbidities identified in > 20% of patients included obesity (50%), anxiety (49%), depression and/or major depressive disorder (46%), and dyslipidemia (26%). Discussions regarding a diagnosis of BED were typically initiated more often by HCPs than patients. Most patients (64%) received a diagnosis of BED ≥ 3 years after symptom onset. A numerically greater percentage of patients received (past or current) nonpharmacotherapy than pharmacotherapy (84% vs. 67%). The mean ± SD number of binge eating episodes/week numerically decreased from pretreatment to follow-up with lisdexamfetamine (5.4 ± 2.8 vs. 1.7 ± 1.2), off-label pharmacotherapy (4.7 ± 3.9 vs. 2.0 ± 1.13), and nonpharmacotherapy (6.3 ± 4.8 vs. 3.5 ± 6.0) Across pharmacotherapies and nonpharmacotherapies, most patients reported improvement in symptoms of BED (84-97%) and in overall well-being (80-96%).
Conclusions:
These findings highlight the importance of timely diagnosis and treatment of BED. Although HCPs are initiating discussions about BED, earlier identification of BED symptoms is required. Furthermore, these data indicate that pharmacologic and nonpharmacologic treatment for BED is associated with decreased binge eating and improvements in overall well-being.
Level of evidence:
IV, chart review.
... According to Grilo [14], 67.0% of BED patients had at least one additional lifetime psychiatric disorder, and 37.0% had at least one current psychiatric disorder, mood and anxiety disorders being the most frequent comorbidities. Approximately, between 30.0 and 80.0% of individuals with BED present lifetime comorbid mood and anxiety disorders [15][16][17][18][19][20], but also some related pathologies such as bipolar disorder [10]. Furthermore, evidence points to impulse control impairments in patients with BED [21]. ...
Binge eating disorder (BED) is a mental illness characterised by recurrent binge eating episodes in the absence of appropriate compensatory behaviours. Consequently, BED is strongly associated with obesity. The current review aims to provide an update of the most relevant aspects of BED (e.g., clinical profile, aetiology and treatment approaches), in order not only to facilitate a better understanding of the disorder and its clinical consequences, but also to identify potential targets of prevention and intervention. Patients with BED often present high comorbidity with other medical conditions and psychiatric disorders. Numerous risk factors have been associated with the development and maintenance of the disorder. Moreover, although some treatments for BED have proven to be effective in addressing different key aspects of the disorder, the rates of patients that have ever received specific treatment for BED are very low. The factors involved and how to implement effective treatments will be discussed for the purpose of addressing the eating symptomatology and comorbid obesity.
... 11 There is wide variability in prevalence across countries. For example, a meta-analysis of studies from Latin American showed a mean point-prevalence of 3.5% for BED. 12 In addition to T2DM, BED is also associated with a number of psychiatric and metabolic conditions including mood disorders, substance use disorders, overweight and obesity, and dyslipidemia [13][14][15][16] as well as impaired health-related quality of life and increased healthcare costs. 17 BED and T2DM each present a number of diagnostic and management obstacles that complicate care of patients with both of these conditions. ...
Jonathan D Chevinsky,1 Thomas A Wadden,2 Ariana M Chao2,3 1SUNY Downstate Health Sciences University, Brooklyn, NY, USA; 2Perelman School of Medicine at the University of Pennsylvania, Department of Psychiatry, Philadelphia, PA, USA; 3University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, Philadelphia, PA, USACorrespondence: Ariana M ChaoUniversity of Pennsylvania School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, USATel +1215-746-7183Fax +1215-898-2878Email arichao@upenn.eduAbstract: Type 2 diabetes mellitus (T2DM) is associated with an increased risk of disordered eating behaviors including binge eating disorder (BED). Comorbid BED in patients with T2DM has been associated with adverse clinical outcomes such as higher body mass index (BMI) and depressive symptoms. Identifying and addressing this disorder in patients with T2DM is a significant challenge for health-care providers. The purpose of this narrative review is to discuss current perspectives on BED in the context of T2DM with implications for screening and management of these highly comorbid conditions. BED continues to be underrecognized and underdiagnosed. However, there are established tools that providers can use to screen for BED such as the SCOFF Questionnaire and Questionnaire on Eating and Weight Patterns-5. There are several effective treatments for BED including cognitive behavioral therapy, interpersonal therapy, and lisdexamfetamine dimesylate. However, few studies have examined the effects of these treatments in patients with co-morbid T2DM and BED.Keywords: binge eating disorder, eating disorders, diabetes, obesity
... We found a correlation between the severity of BED and the severity of depression, anxiety, and fatigue as previously published in several studies on overweight or obese patients. 13,[30][31][32][33] However, the association between NAFLD and depression, anxiety, or fatigue has rarely been studied. [34][35][36] The evaluation of psychological disorders had two complementary interests: to improve the knowledge of the association between psychological disorders and NAFLD and also to ensure that the anxiodepressive participation was not the explanatory parameter linking NAFLD and BED. ...
Background and aim:
The main aim of this study was to evaluate if the binge eating disorders (BEDs) related to obesity were associated with the severity of non-alcoholic fatty liver disease (NAFLD).
Methods:
Severely obese patients who had been referred for bariatric surgery were included in this study at the Nice University Hospital. All patients underwent a liver biopsy at the time of surgery. Between 2008 and 2015, 388 patients had an assessable Bulimia Test (BULIT) self-questionnaire at the time of surgery. A subgroup (n = 183), between 2011 and 2015, also responded to a Beck Depression Inventory, Hospital Anxiety and Depression Scale, and a Fatigue Impact Scale autoquestionnaire. A control group of 29 healthy people matched by age and gender was included.
Results:
Among the 388 obese patients (median age 40 years, body mass index 41.7 kg/m2, 81% women), 14 patients had a "probable diagnosis" of BED, and 47 patients had a "high risk" of developing a BED according to the BULIT. Obese patients had significantly more severe BED, depression, anxiety, and fatigue compared to controls. Steatosis, non-alcoholic steatohepatitis, or fibrosis was not associated with BED. Similarly, the severity of NAFLD was not associated with depression, anxiety, or fatigue.
Conclusions:
Severely obese patients had more severe BED, depression, anxiety, and fatigue than lean subjects independent of the severity of NAFLD.
... Tampoco se especifica si el malestar asociado es previo o posterior al atracón, incluyendo de esta forma patrones cognitivos disímiles en la interacción con el patrón perturbado de ingesta alimentaria. Aun así, existe vasta evidencia de que los diagnósticos de TBP y TDM son los más comunes en pacientes con TA 27 . Específicamente en relación al TA, cuando éste se tRastoRNos del áNimo, NutRiCióN y craving asocia significativamente a trastornos del ánimo la carga de enfermedad aumenta considerablemente, presentando mayor asociación con trastornos de ansiedad, trastorno por uso de sustancias, rasgos de personalidad mal adaptativos y trastornos metabólicos 28 . ...
Objetivos:
La relación entre diversas variaciones de la ingesta alimentaria y los trastornos del ánimo es un fenómeno bien conocido para diversos clínicos. No obstante estos fenómenos han sido escasamente estudiados a la fecha. Los métodos de evaluación del atracón o “craving” son diversos, lo que ha generado hallazgos heterogéneos y superficiales. El objetivo de esta revisión es un análisis de la fenomenología del craving y las diversas relaciones entre nutrición y trastornos del ánimo, específicamente con el trastorno bipolar (TBP).
Método:
Se realizó una revisión narrativa a través de una búsqueda no sistemática de la literatura a través de la base de datos MEDLINE, utilizando términos MeSH.
Resultados:
Los resultados en esta área a la fecha son escasos y diversos. Se evaluó la evidencia a la fecha en torno a la relación bidireccional entre TBP y nutrición, y con trastornos de la conducta alimentaria (TCA), específicamente el trastorno por atracones (TA). Por otro lado se revisó la literatura en cuanto a la comprensión del concepto de craving (antojo o deseo intenso) por carbohidratos, su neurobiología y sus relaciones con los trastornos del ánimo, específicamente con el TBP.
Conclusiones:
A pesar de que los desórdenes analizados aquí presentan relaciones conocidas de larga data por los clínicos dedicados a trastornos del ánimo, la literatura de investigación ha sido bastante limitada acerca de tales relaciones. Considerando las importantes implicancias que pueden llegar a tener en el diagnóstico, evolución y terapéutica de los pacientes, parece necesario un esfuerzo por continuar avanzando en la comprensión de los mecanismos más íntimos de estos trastornos, sus aspectos clínicos y sus diversas relaciones.
... Former studies have found that most individuals with binge eating experience higher rates of depression than normal individuals [10]. Other research has found that people with binge eating often suffer from several types of anxiety disorders [11]. ...
Background:
Eating disorders pose a serious challenge to health services due to psychosocial and medical problems. Binge eating disorder (BED) is characterized as a pattern of overeating episodes followed by shame, distress and guilty feelings. Among eating disorders, BED has the highest prevalence, especially among females. The literature reported that BED is associated with nutritional status, socio-demographic factors, and psychological factors in different countries. This study aims to examine the prevalence of binge eating symptoms and its relationship with selected variables (i.e. socio-demographics, nutritional status and dietary habits).
Methods:
One hundred fifty-four female undergraduate students, from three different faculties at Palestine Polytechnic University, participated in the study. All the students who consented to join the study were assessed in terms of weight status using body mass index, dietary habits and medical profile. The screening for presence of binge eating symptoms was done using BEDS-7. The psychosocial factors were assessed by validated Arabic version of DASS-21.
Results:
Half of the participants (50%) had binge eating symptoms. No association between binge eating symptoms and socio-demographic variables was found. Similarly, binge eating symptoms was not related to body weight status, however, it was associated with eating between meals and number of snacks. A significantly higher score on depression, stress and anxiety was found among binge eaters than non-binge eaters.
Conclusion:
It was concluded that binge eating symptoms have considerable prevalence among the study participants, and it was significantly correlated with psychosocial factors. Future studies are needed to examine other risk factors and correlations. Educational programs are also recommended to increase the awareness of eating disorders as well as to promote healthy eating patterns.
A large number of Veterans experience binge eating and overweight or obesity, which are associated with significant health and psychological consequences. The gold-standard program for the treatment of binge eating, Cognitive Behavioral Therapy (CBT), results in decreases in binge eating frequency but does not result in significant weight loss. We developed the Regulation of Cues (ROC) program to reduce overeating and binge eating through improvement in sensitivity to appetitive cues and decreased responsivity to external cues, an approach that has never been tested among Veterans. In this study, we combined ROC with energy restriction recommendations from behavioral weight loss (ROC+). This study is a 2-arm randomized controlled trial designed to evaluate the feasibility and acceptability of ROC+, and to compare the efficacy of ROC+ and CBT on reduction of binge eating, weight, and energy intake over 5-months of treatment and 6-month follow-up. Study recruitment completed in March 2022. One hundred and twenty-nine Veterans were randomized (mean age = 47.10 (sd = 11.3) years; 41% female, mean BMI = 34.8 (sd = 4.7); 33% Hispanic) and assessments were conducted at baseline, during treatment and at post-treatment. The final 6-month follow-ups will be completed in April 2023. Targeting novel mechanisms including sensitivity to internal cures and responsivity to external cues is critically important to improve binge eating and weight-loss programs among Veterans. Clinicaltrials.govNCT03678766.
Высокая распространенность ожирения и инсулинорезистентности, которые являются патогенетической основой формирования метаболического синдрома (МС), и установленная в ходе плеяды исследований взаимосвязь между метаболическими и тревожно - депрессивными нарушениями диктуют необходимость детального изучения данной проблемы. Цель исследования - выявить вероятные факторы, увеличивающие шанс развития психоэмоциональных нарушений в виде тревоги и депрессии у пациентов с МС, и определить вектор дальнейшего изучения обозначенной проблемы. Материал и методы. Изучены данные 241 больного с метаболическим синдромом, средний возраст которых составил 53,1±12,5 года. Наличие и степень выраженности тревожно - депрессивного расстройства определялись при помощи шкалы тревоги и депрессии (HADS). Потенциальные факторы, оказывающие влияние на развитие психоэмоциональных нарушений тревожно - депрессивного спектра, отбирались по результатам интерпретации данных специально разработанной анкеты. Оценка пищевого поведения и качества жизни проводилась при помощи опросников пищевого поведения (DEBQ), Eating Attitudes Test (EAT-26), опросника SF-36. Результаты. Определены модифицируемые факторы, потенциально увеличивающие шансы развития тревоги и депрессии у пациентов с МС: наряду с принадлежностью к женскому полу, возрастом и неблагоприятными социально - экономическими аспектами жизни, определенный вклад также вносят сахарный диабет 2-го типа и ассоциированные с МС заболевания желудочно - кишечного тракта. Полученные результаты в перспективе поспособствуют выбору оптимальной тактики первичной и вторичной профилактики развития психоэмоциональных расстройств у данной категории больных, однако для получения достоверных результатов необходим логистический регрессионный анализ исследуемой когорты с большим числом наблюдений.
The high prevalence of obesity and insulin resistance, which are the pathogenetic basis for the formation of the metabolic syndrome (MtS), the relationship between metabolic and anxiety - depressive disorders established in the course of a galaxy of studies dictate the need for a detailed study of this problem. Purpose of the study. To identify probable factors that increase the chance of developing psycho - emotional disorders in the form of anxiety and depression in patients with MtS, and to determine the vector for further study of the indicated problem. Material and methods. The data of 241 patients with metabolic syndrome, whose average age was 53,1±12,5 years, studied. The presence and severity of anxiety - depressive disorder was determined using the Anxiety and Depression Scale (HADS). Potential factors influencing the development of psycho - emotional disorders of the anxiety - depressive spectrum selected based on the results of interpreting the data of a specially designed questionnaire. Eating behavior and quality of life were assessed using the Eating Behavior Questionnaire (DEBQ), the Eating Attitudes Test (EAT-26), and the SF-36 questionnaire. Results. Modifiable factors identified that potentially increase the chances of developing anxiety and depression in patients with MS: along with female gender, age, and unfavorable socioeconomic aspects of life, type 2 diabetes mellitus and MtS-associated gastrointestinal diseases make a certain contribution. The results obtained in the future will contribute to the choice of optimal tactics for primary and secondary prevention of the development of psychosocial personality disorders in these patients; however, to obtain reliable results, a logistic regression analysis of the studied cohort with a large number of observations is required.
Objectives. To determine the prevalence and typology, as well as to establish the factors influencing the change of eating behavior in patients with morbid obesity. Material and methods. The method of continuous sampling was used to analyze the incidence of eating disorders types in 154 patients with morbid obesity who underwent planned surgical treatment for obesity at the Center for Herniology and Bariatric Surgery of the 4th City Clinical Hospital named after N.E. Savchenko during the period from 2016 to 2017. Additionally, a survey on the type of eating disorders was carried out in 81 patients with morbid obesity in the pre- and postoperative period after providing bariatric treatment. Results. The prevalence, typology of eating disorders associated with morbid obesity were studied, the assessment of the presence of correlation between body mass index (BMI) and the threshold value of eating disorders, as well as the assessment of changes of eating behavior in patients with morbid obesity in the postoperative period were made. Conclusions. Deviant forms of eating behavior are a specific criterion for morbid obesity with a dominant emocyogenic type of eating disorder with a body mass index of more than 60 kg / m<sup>2</sup>. Performing restrictive or combined bariatric surgery in patients with a restrictive type of eating disorder completely eliminates the existing eating disorder in 12 months after the operation, while maintaining a positive result in the long-term period.
Eating Disorders (ED) are a severe mental illness that causes physical and psychosocial problems. This illness has a higher prevalence among young women, and between athletes. cognitive behavioural therapy (CBT) is the current treatment for this type of disorder. However, more and more programs are including physical exercise (PE) and nutritional therapy (TN) for eating disorders treatment. Objective. To carry out an exploratory systematic review of the literature that allows us to know the current state of intervention programs through physical exercise and nutritional therapy for the treatment of eating disorders. Materials and methods. For the reference search thesame search phrase was used. The terms were entered in English in the following computerized databases: SCOPUS, Web of Science, and PubMed. To limit the search, four inclusion criteria were introduced. Results. The review included five scientific articles related to the study topic, which met the inclusion criteria. Conclusion. Intervention programs for the treatment of eating disorders that include physical exercise and nutritional therapy are shown as an alternative or complementary tool to conventional therapy. These programs involve a reduction in the severity of ED symptoms and an improvement in anthropometric parameters and physical condition. More studies that combine PE and TN programs for people with ED are required.
Existing research on perfectionism and binge eating suggests that socially prescribed, self-oriented, and other-oriented perfectionism (Socially Prescribed Perfectionism, SPP; Self-Oriented Perfectionism, SOP; and Other-Oriented Perfectionism, OOP) are differentially related to binge eating. However, previous studies have largely utilized cross-sectional methodology. The present study used a 20-day daily diary methodology to examine associations between daily levels of perfectionistic dimensions and next-day binge eating behaviors with a nonclinical sample of emerging adults (N = 263). Zero-inflated negative binomial regression models indicated that daily SPP (but not SOP or OOP) predicted a greater intensity of next-day binge eating behaviors in the count portion of the model; however, daily levels of perfectionistic dimensions did not predict the presence/absence of next-day binge eating behaviors in the zero-inflated portion of the model. Additionally, analyses examining the reverse causal direction (i.e., binge eating behaviors predicting higher next-day perfectionism) failed to provide evidence that the occurrence or intensity of binge eating behaviors predicts next-day levels of SPP, SOP, or OOP. Overall, at a daily level, SPP appears to be a vulnerability factor for binge eating behaviors. It may be helpful for clinicians to target state-levels of SPP to reduce harmful binge eating behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
In the last few years, evidences about a more rising risk of developing eating disorders in patients with type 1 and type 2 diabetes have been multiplying in literature, a relation that shall complicate and make the diabetes more instable.
Профессиональная деятельность в условиях Арктики имеет свои особенности, отражающиеся на психоэмоциональном состоянии человека, что может привести к развитию психосоматических состояний и заболеваний. Нами проведена оценка уровня тревожности медицинских сестер психиатрического профиля (55 человек) в условиях Арктики с целью раннего выявления донозологических состояний, профилактики возникновения психоэмоциональных нарушений и психосоматических заболеваний у медицинских сестер. Установлено влияние стажа, возраста и сменности труда на уровень ситуативной и личностной тревожности. Выявлено, что повышение тревожности, которое является симптомом психоэмоционального напряжения, зависит от социальных факторов (доход и семейное положение), сменности труда и ответственности за должностные обязанности руководителя, что может усугубляться как особенностью профессиональной деятельности, так и проживанием в условиях Крайнего Севера.
Professional activity in the conditions of the Arctic has certain features affecting the psychoemotional condition of a person that can lead to the development of psychosomatic disorders and physical diseases. We evaluated the level of anxiety of psychiatric nurses (N=55) in the conditions of the Arctic for the purpose of early identification of premorbid states, prevention of emergence of psycho-emotional disturbances, and psychosomatic diseases in nurses. We determined that work experience, age, and shift work influenced the level of situational and personal anxiety. It was revealed that an increase in anxiety which is a symptom of psychoemotional tension, depended on social factors (income and marital status), shift work, and managerial responsibilities and can be aggravated both with features of professional activity, and accommodation to the conditions of the Far North.
Background
Psychiatric comorbidity is common in binge-eating disorder (BED) but effects on treatment outcomes are unknown. The current study aimed to determine whether psychiatric comorbidity predicted or moderated BED treatment outcomes.
Methods
In total, 636 adults with BED in randomized-controlled trials (RCTs) were assessed prior, throughout, and posttreatment by doctoral research-clinicians using reliably-administered semi-structured interviews, self-report measures, and measured weight. Data were aggregated from RCTs testing cognitive-behavioral therapy, behavioral weight loss, multi-modal (combined pharmacological plus cognitive-behavioral/behavioral), and/or control conditions. Intent-to-treat analyses (all available data) tested comorbidity (mood, anxiety, ‘any disorder’ separately) as predictors and moderators of outcomes. Mixed-effects models tested comorbidity effects on binge-eating frequency, global eating-disorder psychopathology, and weight. Generalized estimating equation models tested binge-eating remission (zero binge-eating episodes during the past month; missing data imputed as failure).
Results
Overall, 41% of patients had current psychiatric comorbidity; 22% had mood and 23% had anxiety disorders. Psychiatric comorbidity did not significantly moderate the outcomes of specific treatments. Psychiatric comorbidity predicted worse eating-disorder psychopathology and higher binge-eating frequency across all treatments and timepoints. Patients with mood comorbidity were significantly less likely to remit than those without mood disorders (30% v. 41%). Psychiatric comorbidity neither predicted nor moderated weight loss.
Conclusions
Psychiatric comorbidity was associated with more severe BED psychopathology throughout treatment but did not moderate outcomes. Findings highlight the need to improve treatments for BED with psychiatric comorbidities but challenge perspectives that combining existing psychological and pharmacological interventions is warranted. Treatment research must identify more effective interventions for BED overall and for patients with comorbidities.
The WHOunderlined the importance of a healthy diet for the psychophysical well-being of the person. Self Determination Theory highlighted how the interaction between contextual, such as peer pressure, and motivational factors play a fundamental role in promoting healthy eating habits. The present study aims to assess if peer pressure affects eating habits and binge eating through the mediation of motivation. Questionnaires were administered to 588 young-adults aged between 18 and 24 years (M = 20.56, DS = 1.78) in the Italian context. Results suggest that Peer Pressure predicted Controlled Motivation and Autonomous Motivation, and that motivation predicted Eating Behaviors and Binge Eating. In addition, Peer Pressure also has a direct effect on Binge Eating. The results confirm the importance of investigating contextual and motivational factors in the area of prevention and intervention in eating habits.
Clinical guidelines have long been one of the working tools of the modern doctor, helping him quickly navigate the most effective proven methods of treatment and prevention of various diseases, and also to adapt these methods to the specific tasks of their patients and to achieve maximum personalization of treatment. Clinical practice guidelines are drawn up by professional non-profit associations and are approved by the Scientific Council of the Ministry of Health of the Russian Federation, while often one recommendation is prepared by two or even three associations. The peculiarity of the recommendations offered to your attention is that not only endocrinologists, but also therapists, cardiologists, gynecologists, gastroenterologists, and experts of many other specialties are involved in the prevention and treatment of obesity. The Multidisciplinary Working Group presents this a project in a multidisciplinary journal to bring together the efforts of several professional associations that associated with the need to pay attention not only to obesity itself but also to comorbid conditions. We are looking forward to constructive criticism and a comprehensive discussion of the problem on the pages of our journal. © 2021 Russian Association of Endocrinologists. All rights reserved.
Binge eating disorder (BED) is a public health problem in several countries. BED is commonly associated with comorbidities such as obesity, diabetes, and depression. Notwithstanding the health problems associated with BED, evidence‐based treatments for BED are not widely used by healthcare professionals worldwide. Thus, we provide an overview of the leading evidence‐based psychological therapies for BED, with the intention of informing healthcare professionals and the general community and facilitating greater provision of treatment. Cognitive behavior therapy (CBT) for BED is briefly presented, focusing mainly on adaptations and stages of the cognitive behavior therapy‐enhanced (CBT‐E) transdiagnostic model for eating disorders. We also succinctly discuss the use of CBT in combination with weight management interventions or pharmacotherapy, as well as the use of interpersonal therapy and dialectical behavior therapy for BED. We conclude that there is a variety of evidence‐based psychological therapies that can be used by a variety of healthcare professionals (not only by psychologists) to help reduce binge eating and associated psychopathology in people with BED. Given the high and increasing prevalence of BED, as well as the availability of effective evidence‐based treatments, we encourage more healthcare professionals to explore up‐skilling to assist people with BED.
Purpose
Emerging work indicates divergence in the neurobiologies of binge-eating disorder (BED) and obesity despite their frequent co-occurrence. This review highlights specific distinguishing aspects of BED, including elevated impulsivity and compulsivity possibly involving the mesocorticolimbic dopamine system, and discusses implications for differential therapeutics for BED.
Methods
This narrative review describes epidemiologic, clinical, genetic, and preclinical differences between BED and obesity. Subsequently, this review discusses human neuroimaging work reporting differences in executive functioning, reward processing, and emotion reactivity in BED compared with obesity. Finally, on the basis of the neurobiology of BED, this review identifies existing and new therapeutic agents that may be most promising given their specific targets based on putative mechanisms of action relevant specifically to BED.
Findings
BED is characterized by elevated impulsivity and compulsivity compared with obesity, which is reflected in divergent neurobiological characteristics and effective pharmacotherapies. Therapeutic agents that influence both reward and executive function systems may be especially effective for BED.
Implications
Greater attention to impulsivity/compulsivity-related, reward-related, and emotion reactivity–related processes may enhance conceptualization and treatment approaches for patients with BED. Consideration of these distinguishing characteristics and processes could have implications for more targeted pharmacologic treatment research and interventions.
Binge eating patients present lower physical activity levels, which could be associated with lower exercise capacity. Specific physical activity can ensure broad beneficial results relating to eating disorders, depression, and body mass index (BMI) in bulimia; however, research on binge eating disorder (BED) is scarce. Our study aimed to investigate the effects of specific training as an addition to conventional treatment of eating disorder symptoms, anthropometric characteristics, and physical performance. Nineteen women with BED were included in a dietary and cognitive-behavioral therapy program. After medical examination, 10 women carried out Combined Aerobic and Anaerobic Exercise Training in addition to conventional treatment (CAAET group), whereas the remaining 9 followed the conventional treatment alone (CTRL group). All of the measurements were assessed before and after six months of treatment. In both groups, we observed a significant decrease in binge episodes, weight, and body mass index, and an increase in exercise capacity. Moreover, the CAAET group presented a greater improvement in aerobic performance than that observed in the CTRL group. Our results suggest that both interventions similarly improved BED symptoms. The addition of physical activity could be important in the long-term maintenance of both weight loss and reduction in binge episodes in BED patients.
In humans, binge eating (BE) is central to the harmful effects of bulimia and binge eating disorder (BED). An estimated 30% of the obese population in the United States meets the diagnostic criteria for BED. Thus, BED is likely a major contributor to the current obesity epidemic. We developed a novel model to examine binge-like eating behavior in rodents that utilizes a schedule of 24-h weekly access to a highly palatable, nutritionally complete energy-dense diet (HED). This method for inducing BE has advantages over previous methods in that it does not require the use of exogenous stressors, caloric restriction, or entrained food anticipatory activity to induce the binge episode. Herein, we report that the BE response induced by this intermittent feeding paradigm can be maintained for at least 9 months in C57BL/6 mice. However, answers to a fundamental question remain. Can BE increase the risk of metabolic syndrome above and beyond the risk associated with obesity alone? Recent evidence in humans and rodents suggests that this may be the case. Given the high prevalence of BED in obesity, it is to be expected that there will be metabolic consequences of BE in this model and potentially in other BE models. However, the exact nature and if it is similar to that observed in frank obesity remains to be determined. We report on what is known about the metabolic consequences of long-term exposure to BE in mice with 24-h weekly access to an HED. While the changes we observed are subtle, over time they could have a significant impact on overall metabolism. Alterations in opioid receptor signaling pathways after repeated bingeing are discussed and may be one mechanism that links binge-like eating behavior with peripheral metabolism. Mice have particular advantages as a preclinical model mainly due to the sophisticated genetic techniques that are available in this species. Extensive characterization of the physiological, behavioral, and molecular changes associated with intermittent access to palatable diets will provide opportunities to identify and test novel therapeutic approaches to reduce BE and to understand its clinical translatability.
Background.:
The nature and significance of impulse-control difficulties in binge-eating disorder (BED) are uncertain. Most emerging research has focused on food-specific rather than general impulsivity. The current study examines the clinical presentation of patients with BED categorized with and without clinical levels of general impulsivity.
Method.:
A total of 343 consecutive treatment-seeking patients with BED were categorized as having BED with general impulsivity (GI+; N = 73) or BED without general impulsivity (GI-: N = 270) based on structured diagnostic and clinical interviews. The groups were compared on demographic, developmental, and psychological features, and on rates of psychiatric and personality comorbidity.
Results.:
Individuals with BED and general impulsivity (GI+) reported greater severity of eating-disorder psychopathology, greater depressive symptoms, and greater rates of comorbidity than those without general impulsivity (GI-).
Conclusions.:
A subtype of individuals with BED and general impulsivity may signal a more severe presentation of BED characterized by heightened and broader psychopathology. Future work should investigate whether these impulse-control difficulties relate to treatment outcomes.
Background and Aims
Binge eating disorder (BED) is correlated with substance use. This study aimed to estimate the lifetime prevalence of alcohol use disorder (AUD) among individuals with non‐compensatory binge eating and determine whether their lifetime prevalence of AUD is higher than in non‐bingeing controls.
Design
A systematic search of databases (PubMed, Embase, and Web of Science) for studies of adults diagnosed with BED or a related behavior that also reported the lifetime prevalence of AUD was conducted. The PRISMA protocol was followed. The protocol was registered on PROSPERO.
Setting
Studies originating in Canada, Sweden, the United Kingdom, and the United States.
Participants
18 studies meeting the inclusion criteria were found, representing 69,233 individuals.
Measurements: Lifetime prevalence of AUD among individuals with binge eating disorder and their lifetime relative risk of AUD compared with individuals without this disorder.
Findings
The pooled lifetime prevalence of AUD in individuals with binge eating disorder was 19.9% (95% CI 13.7‐27.9). The risk of lifetime AUD incidence among individuals with binge eating disorder was over 1.5 times higher than controls (RR 1.59, 95% CI 1.41‐1.79). Lifetime AUD prevalence was higher in community samples than in clinical samples (27.45% vs. 14.45%, p = 0.041) and in studies with a lower proportion of women (β = ‐2.27, p = 0.044).
Conclusions
Lifetime alcohol use disorder appears to be more prevalent with binge eating disorder than among those without.
Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Background
Binge eating disorder (BED) is the most prevalent eating disorder. We examined the presence of binge eating (BE) and three associated eating behaviors in relation to subcortical regional volumes and cortical thickness from brain scans.
Methods
We processed structural MRI brain scans for 466 individuals from the Nathan Kline Institute Rockland Sample using Freesurfer. We investigated subcortical volumes and cortical thicknesses among those with and without BE and in relation to the scores on dietary restraint, disinhibition, and hunger from the Three-Factor Eating Questionnaire (TFEQ). We conducted a whole-brain analysis and a region of analysis (ROI) using a priori regions associated with BE and with the three eating factors. We also compared scores on the three TFEQ factors for the BE and non-BE.
Results
The BE group had higher scores for dietary restraint (p = .013), disinhibition (p = 1.22E-07), and hunger (p = 5.88E-07). In the whole-brain analysis, no regions survived correction for multiple comparisons (FDR corrected p<0.01) for either BE group or interaction with TFEQ. However, disinhibition scores correlated positively with left nucleus accumbens (NAc) volume (p < 0.01 FDR corrected). In the ROI analysis, those with BE also had greater left NAc volume (p = 0.008, uncorrected) compared to non-BE.
Limitations
Limitations include potential self-report bias on the EDE-Q and TFEQ.
Conclusions
The findings show that BE and disinhibition scores were each associated with greater volumes in the left NAc, a reward area, consistent with a greater drive and pleasure for food.
Binge eating in humans is driven by hedonic properties of food, suggesting that brain reward systems may contribute to this behaviour. We examined the role of mu opioid receptors (MOP) in binge eating by examining sweet solution intake in mice with genetic deletion of the MOP. Wildtype and MOP knockout mice had 4 hours access to food in the home cage combined with limited (4 hours) access to sucrose (17.1% w/v) or saccharin (0.09% w/v), or continuous (24 hours) access to sucrose. Only limited access groups exhibited binge intake, measured as increased solution consumption during the first hour. Knockout mice consumed less solution and food during the first hour as well as less food each day compared with wildtype mice. Limited access groups consumed more food and gained more weight than continuous access groups, and the effect was magnified in saccharin-consuming mice. Indeed, the increased food consumption in animals given limited access to saccharin was so excessive that caloric intake of this group was significantly higher than either of the sucrose groups (limited or continuous access). Within this group, females consumed more food per bodyweight than males, highlighting important sex differences in feeding behaviours under restricted access schedules.
Background:
Pharmacological treatment approaches for eating disorders, such as binge eating disorder and bulimia nervosa, are currently limited.
Methods and aims:
Using a well-characterized animal model of binge eating, we investigated the epigenetic regulation of the A2A Adenosine Receptor (A2AAR) and dopaminergic D2 receptor (D2R) genes.
Results:
Gene expression analysis revealed a selective increase of both receptor mRNAs in the amygdaloid complex of stressed and restricted rats, which exhibited binge-like eating, when compared to non-stressed and non-restricted rats. Consistently, pyrosequencing analysis revealed a significant reduction of the percentage of DNA methylation but only at the A2AAR promoter region in rats showing binge-like behaviour compared to the control animals. Focusing thus on A2AAR agonist (VT 7) administration (which inhibited the episode of binge systemically at 0.1 mg/kg or intra-central amygdala (CeA) injection at 900 ng/side) induced a significant increase of A2AAR mRNA levels in restricted and stressed rats when compared to the control group. In addition, we observed a significant decrease in A2AAR mRNA levels in rats treated with the A2AAR antagonist (ANR 94) at 1 mg/kg. Consistent changes in the DNA methylation status of the A2AAR promoter were found in restricted and stressed rats after administration of VT 7 or ANR 94.
Conclusion:
We confirm the role of A2AAR in binge eating behaviours, and we underline the importance of epigenetic regulation of the A2AAR gene, possibly due to a compensatory mechanism to counteract the effect of binge eating. We suggest that A2AAR activation, inducing receptor gene up-regulation, could be relevant to reduction of food consumption.
This study examined the reliability and validity of binge eating disorder (BED), which has been proposed for inclusion in the Diagnostic and Statistical Manual of Mental Disorders ([DSM] 4th ed.; American Psychiatric Association, in press). The interrater reliability of the BED diagnosis compared favorably with that of most diagnoses in the revised third edition of the DSM. To assess validity, we compared obese individuals with and without BED and bulimia nervosa patients. BED subjects differed from the non-BED obese group on variables related to dieting and weight histories but did not differ significantly on other important variables, including measures of psychopathology. When compared with bulimia nervosa patients, subjects with BED had significantly less psychopathology and reported significantly less dietary restraint. This study lends some support to the concept of BED but suggests that additional studies of the characteristics of this disorder at different degrees of obesity would be useful.
This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for DSM-III-R Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates for major depression, any Axis I disorder, and any Axis II disorder relative to controls. BED women also evidenced greater eating and psychiatric symptomatology than did controls. Results suggest that the prevalence of comorbid psychiatric disorders in BED may be lower than previously indicated by clinical studies.
Affective spectrum disorder (ASD) represents a group of psychiatric and medical conditions, each known to respond to several chemical families of antidepressant medications and hence possibly linked by common heritable abnormalities. Forms of ASD include major depressive disorder (MDD), attention-deficit/hyperactivity disorder, bulimia nervosa, cataplexy, dysthymic disorder, fibromyalgia, generalized anxiety disorder, irritable bowel syndrome, migraine, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, premenstrual dysphoric disorder, and social phobia. Two predictions of the ASD hypothesis were tested: that ASD, taken as a single entity, would aggregate in families and that MDD would coaggregate with other forms of ASD in families.
Probands with and without MDD, together with their first-degree relatives, were interviewed using the Structured Clinical Interview for DSM-IV and a supplemental interview for other forms of ASD. The familial aggregation and coaggregation of disorders were analyzed using proband predictive logistic regression models, including a novel bivariate model for the presence or absence of each of 2 disorders in a relative as predicted by the presence or absence of each of 2 disorders in the associated proband.
In the 178 interviewed relatives of 64 probands with MDD and 152 relatives of 58 probands without MDD, the estimated odds ratio (95% confidence interval) for the familial aggregation of ASD as a whole was 2.5 (1.4-4.3; P =.001) and for the familial coaggregation of MDD with at least one other form of ASD was 1.9 (1.1-3.2; P =.02).
Affective spectrum disorder aggregates strongly in families, and MDD displays a significant familial coaggregation with other forms of ASD, taken collectively. These results suggest that forms of ASD may share heritable pathophysiologic features.
To explore the extent to which binge eating in the absence of compensatory behaviors (BE) is associated with psychiatric and medical symptoms in men and women and to control for the independent effects of BMI.
A series of regression models was applied to questionnaire data on 8045 twins, 18 to 31 years old, from a population-based Norwegian registry.
BE was significantly associated with elevated obesity, overweight, symptoms of eating disorders, symptoms of anxiety and depression, panic attacks, depressive episodes, and reduced life satisfaction in both men and women. In women, BE was independently associated with insomnia and early menarche. In men, BE was independently associated with specific phobia, daily smoking, alcohol use, use of pain medication, impairment due to mental health, neck-shoulder, lower back, and chronic muscular pain, and impairment due to physical health. Both men and women with BE reported higher rates of psychiatric treatment.
Our results indicate that there is substantial comorbidity between BE and psychiatric symptoms independently of BMI for both men and women. Medical symptoms co-occur less frequently than previously reported from treatment-seeking populations in women. Across all domains, the array of symptoms exhibited by men with BE was broader than that observed in women with BE. This observation suggests the importance of considering gender differences in future studies of psychiatric and medical morbidity, binge eating, and obesity.
Binge-eating disorder (BED)-a syndrome that only recently has attracted scientific attention-is often seen in obese individuals, especially those with severe obesity. However, it remains unclear whether BED represents an etiologically distinct behavioral phenotype of obesity or simply a nonspecific eating pattern sometimes seen in obese individuals.
To test whether BED aggregates in families independently of obesity, and if so, whether familial factors for BED also independently increase the risk of obesity.
Blinded family interview study of overweight or obese probands with (n = 150) and without (n = 150) BED, and their first-degree relatives (n = 888) in a community setting evaluated between October 2002 and July 2004.
Lifetime diagnosis of BED; current and highest lifetime body mass index (calculated as the weight in kilograms divided by the square of the height in meters).
Binge-eating disorder aggregated strongly in families independently of obesity (odds ratio, 2.2; 95% confidence interval, 1.4-3.6; P<.001). Furthermore, relatives of probands with BED displayed a markedly higher prevalence of severe obesity in adulthood (body mass index >/=40) than relatives of probands without BED even when controlling for proband body mass index (odds ratio, 2.5; 95% confidence interval, 1.4-4.4; P = .002).
Binge-eating disorder is a familial disorder caused in part by factors distinct from other familial factors for obesity. Furthermore, these BED-specific familial factors may independently increase the risk of obesity, especially severe obesity. It follows that targeted interventions capable of preventing or treating traits influenced by these BED-specific familial factors could reduce the public health burden of obesity.
Little population-based data exist on the prevalence or correlates of eating disorders.
Prevalence and correlates of eating disorders from the National Comorbidity Replication, a nationally representative face-to-face household survey (n = 9282), conducted in 2001-2003, were assessed using the WHO Composite International Diagnostic Interview.
Lifetime prevalence estimates of DSM-IV anorexia nervosa, bulimia nervosa, and binge eating disorder are .9%, 1.5%, and 3.5% among women, and .3% .5%, and 2.0% among men. Survival analysis based on retrospective age-of-onset reports suggests that risk of bulimia nervosa and binge eating disorder increased with successive birth cohorts. All 3 disorders are significantly comorbid with many other DSM-IV disorders. Lifetime anorexia nervosa is significantly associated with low current weight (body-mass index <18.5), whereas lifetime binge eating disorder is associated with current severe obesity (body-mass index > or =40). Although most respondents with 12-month bulimia nervosa and binge eating disorder report some role impairment (data unavailable for anorexia nervosa since no respondents met criteria for 12-month prevalence), only a minority of cases ever sought treatment.
Eating disorders, although relatively uncommon, represent a public health concern because they are frequently associated with other psychopathology and role impairment, and are frequently under-treated.
Diagnostic criteria for binge eating disorder (BED) appear in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as "criteria for further study." Few epidemiological studies of BED have been conducted. Our aim was to describe the prevalence and correlates of BED, as assessed by the Patient Health Questionnaire (PHQ) in a community sample.
Descriptive epidemiology from a survey of 910 randomly ascertained participants residing in the greater metropolitan area of St Louis, Mo.
Sixty individuals (6.6%) screened positive for current BED, as assessed by the PHQ (BED+). Men were as likely to screen positive as women. BED+ subjects were at substantially elevated odds for depression, generalized anxiety disorder, panic attacks, and past suicide attempts; individuals with obesity who screened negative for BED (BED-) were not at elevated odds for these syndromes. BED+ subjects, but not other obese individuals, exhibited substantially lower scores on measures of mental health-related quality of life. Personality traits associated with BED symptoms included high Novelty Seeking, high Harm Avoidance, and low Self-directedness. Personality and psychiatric profiles in obese, BED- individuals were closer to those for normal-weight, BED- individuals, suggesting that BED is distinct from typical obesity. BED+ subjects reported mean body mass index of 34.1, more than 6 units above BED- subjects.
PHQ-BED criteria are associated with substantial impairment, psychiatric comorbidity, and obesity and effectively discriminate obese individuals with psychological problems from obese subjects without similar problems. BED may be considerably more prevalent than other eating disorders and equally prevalent among men and women.
This paper proposes an extension of generalized linear models to the analysis of longitudinal data. We introduce a class of
estimating equations that give consistent estimates of the regression parameters and of their variance under mild assumptions
about the time dependence. The estimating equations are derived without specifying the joint distribution of a subject's observations
yet they reduce to the score equations for niultivariate Gaussian outcomes. Asymptotic theory is presented for the general
class of estimators. Specific cases in which we assume independence, m-dependence and exchangeable correlation structures from each subject are discussed. Efficiency of the pioposecl estimators
in two simple situations is considered. The approach is closely related to quasi-likelihood.
235 Ss provided self-report data on how often 22 different bad things happened to them and 173 other Ss estimated the percentage of the people, like themselves, who would choose each of 4 given alternatives. The 4 key items were sexual abuse and physical abuse by family and nonfamily members. Total frequency of negative events was low; the sexes did not differ in frequency of negative events across the total scale. Females did report significantly more sexual or physical abuse by family than nonfamily members. Males who reported 1 or more kinds of abuse did not differ on the other 18 items from those who did not. Females who reported 1 or more kinds of abuse also reported more frequent negative events experienced with regard to the other 18 items. Those Ss who estimated the frequency with which bad things happened to others believed that these negative events happened far more often than the frequencies obtained from self-report data. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study compared the prevalence of psychiatric disorders among obese binge eaters (n = 25) and obese non—binge eaters (n = 25) of similar age and weight. Subjects were interviewed by clinicians who were blind to the patients' binge status using the Diagnostic Interview Schedule. Sixty percent of bingers met criteria for one or more psychiatric disorders, compared with 28% of nonbingers, with differences most apparent in affective disorder; 32% of obese bingers reported a history of affective disorder versus only 8% of nonbingers. Obese binge eaters also reported significantly more psychiatric symptoms, especially symptoms of depression, anxiety, and sexual dysfunction.
We introduce a method of estimating disease prevalence from case-control family study data. Case-control family studies are performed to investigate the familial aggregation of disease; families are sampled via either a case or a control proband, and the resulting data contain information on disease status and covariates for the probands and their relatives. Here, we introduce estimators for overall prevalence and for covariate-stratum-specific (e.g., sex-specific) prevalence. These estimators combine the proportion of affected relatives of control probands with the proportion of affected relatives of case probands and are designed to yield approximately unbiased estimates of their population counterparts under certain commonly made assumptions. We also introduce corresponding confidence intervals designed to have good coverage properties even for small prevalences. Next, we describe simulation experiments where our estimators and intervals were applied to case-control family data sampled from fictional populations with various levels of familial aggregation. At all aggregation levels, the resulting estimates varied closely and symmetrically around their population counterparts, and the resulting intervals had good coverage properties, even for small sample sizes. Finally, we discuss the assumptions required for our estimators to be approximately unbiased, highlighting situations where an alternative estimator based only on relatives of control probands may perform better.
Recent evidence suggests that a number of psychiatric and medical conditions may be members or candidate members of a larger family of conditions, which we have termed "affective spectrum disorder (ASD)." In order to facilitate further research into this concept, we drafted seven interview modules, using the format of the Structured Clinical Interview for DSM-III-R (SCID), designed to diagnose the following psychiatric and medical disorders: irritable bowel syndrome, narcolepsy, Tourette's disorder, migraine, fibromyalgia, chronic fatigue syndrome, and kleptomania.
Published operational diagnostic criteria for these seven disorders were sought in the literature. Questions in SCID format were then drafted in accordance with these operational criteria. Draft modules were then sent to experts familiar with each of the disorders and suggestions and revisions from these experts incorporated into the final modules.
The complete supplemental interview is presented with this report. Preliminary experience with this interview in more than 100 patients tentatively suggests that it is reliable for diagnosing the disorders in question; however, a formal test-retest reliability assessment is still required.
It is hoped that this supplemental interview, used in conjunction with the SCID, will be helpful in further studies of the epidemiology, pathogenesis, and treatment of these possible forms of affective spectrum disorder.
We compared 23 obese subjects meeting DSM-III criteria for bulimia with 47 obese nonbulimic subjects and 47 normal-weight bulimic subjects using structured diagnostic interviews. The obese bulimic subjects were similar to the normal-weight bulimic subjects but different from the nonbulimic obese subjects in exhibiting a high lifetime rate of major affective disorder. However, the obese bulimic subjects were much less likely than the normal-weight bulimic subjects to use self-induced vomiting as a method of purging. These results suggest that obese individuals with bulimic symptoms may constitute a sizable but little-recognized population. Further studies will be required, however, to assess whether the syndrome of bulimia in obesity represents a valid diagnostic entity.
The authors determined the prevalence of binge eating disorder in a self-referred study group of moderately and severely obese subjects and investigated whether binge eating disorder was associated with psychiatric disorders, a history of psychotherapy, a family history of psychiatric illness, or a history of sexual abuse.
They interviewed 89 obese women and 39 obese men (body mass index > 30 kg/m2) who were not currently in weight loss treatment, using the Binge Eating Disorder Clinical Interview, the Structured Clinical Interview for DSM-III-R, and the Structured Clinical Interview for DSM-III-R Personality Disorders.
Forty-three (34%) of the subjects met criteria for binge eating disorder--33 women and 10 men. Black and white subjects had similar rates of binge eating disorder. Subjects with binge eating disorder were significantly more likely than those without the disorder to have a lifetime prevalence of a DSM-III-R axis I or axis II diagnosis and to have undergone psychotherapy or counseling. The lifetime rates of major depression, panic disorder, bulimia nervosa, borderline personality disorder, and avoidant personality disorder were all significantly higher in subjects with binge eating disorder. The rate of reported sexual abuse was not higher among subjects with binge eating disorder; however, they were significantly more likely to have a family history of substance abuse. The relative risks for psychiatric disorders were higher in both moderately and severely obese subjects with binge eating disorder than in those without the disorder.
Among both moderately and severely obese subjects, binge eating disorder is associated with higher rates of axis I and axis II psychiatric disorders.
Binge eating disorder (BED) is a new eating disorder that describes the eating disturbance of a large number of individuals who suffer from recurrent binge eating but who do not regularly engage in the compensatory behaviors to avoid weight gain seen in bulimia nervosa. This multisite study of BED involved 1,785 subjects drawn from 18 weight control programs, 942 subjects from five nonpatient community samples, and 75 patients with bulimia nervosa. Approximately 29% of subjects in weight control programs met the criteria for BED. In the nonpatient community samples BED was more common than purging bulimia nervosa. The validity of BED was supported by its strong association with (1) impairment in work and social functioning, (2) overconcern with body/shape and weight, (3) general psychopathology, (4) significant amount of time in adult life on diets, (5) a history of depression, alcohol/drug abuse, and treatment for emotional problems.
To investigate differences in clinical characteristics of obese female participants based on presence and degree of binge eating behavior.
Descriptive comparison of various clinical characteristics of obese women diagnosed with binge eating disorder (BED) assessed by semi-structured interview to those for similar weight participants reporting subthreshold BED and those who do not binge eat. SUBJECTS. 185 healthy women seeking obesity treatment (age: 20-55 y, BMI: 28.4-51.5 kg/m2).
Baseline self-report questionnaires included the Weight and Eating Patterns (QEWP), Eating Disorders Questionnaire (EDQ), Beck Depression Inventory (BDI); clinical interviews included the Hamilton Depression Rating Scale (HDRS) and Structured Clinical Interview for DSM-III-R-Patient Version (SCID-P).
In comparison to other obese women, obese participants meeting full BED criteria report an earlier onset of binge eating, increased food cravings, increased diet pill use, decreased fasting, greater fear of gaining weight, increased body perception disturbance, and increased depressive symptomatology and general psychopathology.
Obese women with BED report greater eating-related and general psychopathology than non-binge eating disordered women of comparable weight. Although endorsement of food cravings unrelated to hunger was associated with binge eating diagnosis, the role of dietary restriction among this population remains unclear and requires further investigation. Theoretical and clinical implications that binge eating episodes for individuals with BED may be related to negative affect states and increased dietary disinhibition are discussed.
This article examined the prevalence of binge eating disorder (BED), obesity, and depressive symptomatology in a biracial, population-based cohort of men and women participating in a longitudinal study of cardiovascular risk factor development. The Revised Questionnaire on Eating and Weight Patterns was used to establish BED status among the 3,948 (55% women, 48% Black) participants (age 28-40 years). Body mass index (BMI: kg/m2) was used to define overweight (BMI > or = 27.3 in women and > or = 27.8 in men). Depressive symptomatology was assessed with the Center for Epidemiologic Study Depression Scale. Prevalence of BED was 1.5% in the cohort overall, with similar rates among Black women, White women, and White men. Black men had substantially lower BED rates. Depressive symptomatology was markedly higher among individuals with BED. Among overweight participants, BED prevalence (2.9%) was almost double that of the overall cohort. There were no differences in BED rates between over-weight Black and White women. Thus, BED was common in the general population, with comparable rates among Black women, White women, and White men, but low rates among Black men. Obesity was associated with substantially higher prevalence of BED. Treatment studies that target obese men and minority women with BED are indicated.
To examine the clinical features of subthreshold binge eating disorder (BED).
Participants were recruited directly from the community as part of an ongoing study of risk factors for BED. Forty-four women with subthreshold BED were compared with 44 women with BED and 44 healthy controls on demographic characteristics, body mass index (BMI), eating disorder symptomatology, and psychiatric distress. Diagnoses were established using the Eating Disorder Examination (EDE). Participants completed the EDE-Questionnaire, the Brief Symptom Inventory, and were measured and weighed.
Adjusting for significant group differences in BMI, the two eating disorder groups did not differ significantly on measures of weight and shape concern, restraint, psychiatric distress, and history of seeking treatment for an eating or weight problem.
Given the importance of diagnostic status for access to treatment, further evaluation of the severity criterion specified for BED is needed.
Comorbid or extraintestinal symptoms occur frequently with irritable bowel syndrome and account for up to three fourths of excess health care visits. This challenges the assumption that irritable bowel is a distinct disorder. The aims of this study were to (1) assess comorbidity in 3 areas: gastrointestinal disorders, psychiatric disorders, and nongastrointestinal somatic disorders; and (2) evaluate explanatory hypotheses.
The scientific literature since 1966 in all languages cited in Medline was systematically reviewed.
Comorbidity with other functional gastrointestinal disorders is high and may be caused by shared pathophysiological mechanisms such as visceral hypersensitivity. Psychiatric disorders, especially major depression, anxiety, and somatoform disorders, occur in up to 94%. The nongastrointestinal nonpsychiatric disorders with the best-documented association are fibromyalgia (median of 49% have IBS), chronic fatigue syndrome (51%), temporomandibular joint disorder (64%), and chronic pelvic pain (50%).
Multivariate statistical analyses suggest that these are distinct disorders and not manifestations of a common somatization disorder, but their strong comorbidity suggests a common feature important to their expression, which is most likely psychological. Some models explain the comorbidity of irritable bowel with other disorders by suggesting that each disorder is the manifestation of varying combinations of interacting physiological and psychological factors. An alternative hypothesis is that the irritable bowel diagnosis is applied to a heterogeneous group of patients, some of whom have a predominantly psychological etiology, whereas others have a predominantly biological etiology, and that the presence of multiple comorbid disorders is a marker for psychological influences on etiology.
To determine the prevalence of obesity and binge eating in a population-based sample of female twins and to examine whether the presence of binge eating was associated with a greater risk for medical and psychiatric disorders in obese women.
A population-based study of twins who were born between 1934 and 1971 and both members responded to a mailed questionnaire (individual response rate was conservatively estimated to be 64%). Data for the present study are from the first and third interview waves. In Wave 1 (1987-1989), we assessed 92% of the eligible individuals (N = 2,163), 90% face-to-face and the remainder by telephone. We assessed lifetime history of psychiatric disorders, major medical disorders, health limitations, health satisfaction, and an array of personality and attitudinal measures.
Obese women with binge eating reported greater health dissatisfaction and higher rates of major medical disorders than obese women without binge eating. Binge eating was also associated with higher lifetime prevalence of major depression, panic disorder, phobias, and alcohol dependence. Obese women with binge eating scored higher on neuroticism and symptom scales measuring depression, anxiety/phobia, and neurovegetative symptoms (i.e., insomnia, agitation, retardation, and obsessive-compulsive traits).
The presence of binge eating in obese women is a marker for greater medical and psychiatric morbidity.
The diagnostic criteria for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) establish symptom severity levels, which are used to separate full cases from partial cases. However, the value of these distinctions is unclear.
Three hundred eighty-five women with full or partial AN, BN, or BED were assessed at entry into a longitudinal study of eating disorders.
Stepwise discriminant analysis revealed that full and partial BN were discriminated by the Yale-Brown-Cornell Eating Disorders Scale total scores (kappa =.46). However, it was not possible to discriminate between full and partial AN or BED. Discriminant analysis also demonstrated clear differences between full AN, BN, and BED.
Full BN can be differentiated from partial BN by more severe eating disorder symptoms, whereas both full and partial AN and full and partial BED appear quite similar. These results emphasize the distinct nature of AN, BN, and BED, as well as the similarities between full and partial cases.
We compared sociodemographic characteristics and psychiatric status in obese Brazilian patients who did (n=32) and did not (n=33) meet DSM-IV criteria for binge-eating disorder (BED). The sample's mean age was 35.0 years (+/-10.5), with 92.3% of individuals being female and 41.5% having some higher education. Obese binge eaters (OBE) were significantly more likely than obese non-binge eaters to meet criteria for a current diagnosis of any axis I disorder, any mood disorder and any anxiety disorder. Specifically, OBE patients were characterized by significantly higher rates of current and lifetime histories of major depressive disorder. Similar to patients from developed countries, Brazilian patients with BED display increased rates of psychiatric comorbidity, particularly mood and anxiety disorders.
Fibromyalgia is one member of a proposed group of psychiatric and medical disorders, collectively termed affective spectrum disorder (ASD), hypothesized to share possibly heritable pathophysiologic features. Two predictions of the ASD hypothesis were tested: ASD, taken as a single entity, aggregates in families; and fibromyalgia coaggregates with other forms of ASD in families.
Probands with and without fibromyalgia, together with their first-degree relatives, were administered structured diagnostic interviews. Noninterviewed relatives were diagnosed according to information provided by interviewed relatives. Aggregation and coaggregation of disorders were analyzed with proband predictive logistic and linear regression models.
In 533 relatives of 78 probands with fibromyalgia and 272 relatives of 40 probands without fibromyalgia, the estimated odds ratio (OR) (95% confidence interval) for the familial aggregation of ASD was 1.8 (.97, 3.2), p = .065, and the increase in number of forms of ASD in a relative for each additional form of ASD in a proband was .076 (.027, .1240), p = .002. The OR for the coaggregation of fibromyalgia with other forms of ASD was 2.0 (1.2, 3.2), p = .004; this remained significant even after excluding all mood-disorder diagnoses: 1.8 (1.1, 3.0), p = .012.
These findings support familial aggregation of ASD collectively and familial coaggregation of fibromyalgia with other forms of ASD.
There are mounting data supporting comorbidity of fibromyalgia syndrome (FMS) and psychiatric conditions. These include depression, panic disorders, anxiety, and post-traumatic stress disorder (PTSD). The nature of the relationship between depression and FMS is not fully understood, and it was hypothesized that chronic pain causes depression, or vice versa, and that chronic pain syndromes are variants of depression. A link between PTSD symptoms and FMS has been reported, and both conditions share similar symptomatology and pathogenetic mechanisms. Assessment of comorbid psychiatric disorders in FMS patients has clinical implications because treatment in these patients should focus both on physical and emotional dimensions of dysfunction.
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