Binge Eating in Overweight Treatment-Seeking Adolescents

Unit on Growth and Obesity, DEB, NICHD, NIH, 10 Center Drive, CRC, Room 1-3330 MSC 1103, Bethesda, Maryland 20892-1103, USA.
Journal of Pediatric Psychology (Impact Factor: 2.91). 06/2006; 32(1):95-105. DOI: 10.1093/jpepsy/jsl012
Source: PubMed


To examine the frequency and recency of binge eating in relation to psychopathology in overweight, treatment-seeking adolescents.
We investigated psychological correlates of the frequency and recency of reported loss of control (LOC) eating episodes in 160 overweight (body mass index [BMI]: 40.7 +/- 8.8 kg/m(2)) adolescents. On the basis of the responses to the eating disorder examination (EDE), participants were categorized into one of four groups: full-syndrome binge eating disorder (BED); recent but infrequent binge eating (episodes within the 3 months before interview; RECENT-BINGE); remote and infrequent LOC eating (episodes occurring >3 months before assessment; PAST-LOC), or no history of LOC episodes (NE).
The BED group reported higher EDE scores (global, p < .01), and more negative mood and anxiety than all other groups (p's < .01). Compared with NE, RECENT-BINGE also reported more anxiety and higher EDE scores (p's < .01).
Overweight, treatment-seeking adolescents with BED are clearly distinguishable from teens without the disorder on measures of eating-related psychopathology, mood, and anxiety. RECENT-BINGE, but not PAST-LOC, is also associated with significantly greater eating-related and general psychopathology.

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    • "LOC eating was defined by the presence of one or more OBE or SBE in the previous month. The EDE has good inter-rater reliability for all episode types for adolescents (Glasofer et al., 2007). "
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    ABSTRACT: Preliminary data in adults suggest that binge eating is associated with greater prevalence of metabolic syndrome (MetS) components. However, there are limited data in youth, and little is known of the role of binge episode size in these relationships. We examined the relationship between loss of control eating and metabolic characteristics in a convenience sample of 329 treatment-seeking and non-treatment-seeking adolescent boys and girls. The sample was enriched by design with adolescents who were overweight or obese and with individuals who reported episodes of loss of control over their eating (either objectively large binge episodes, OBEs or subjectively large binge episodes, SBEs, in the past month), as assessed by clinical interview. MetS components (blood pressure, lipids, glucose, and waist circumference) were the primary variables of interest. 46% of the cohort reported loss of control eating; among those, 53% reported SBEs only and 47% reported OBEs. Youth with loss of control eating had higher systolic blood pressure (p=.001) and higher low-density lipoprotein cholesterol (LDL-c) (p=.002) compared to those without loss of control eating, in analyses adjusted for intervention-seeking status, fat mass and sociodemographic characteristics. Youth reporting OBEs had higher LDL-c (p=.013) compared to those reporting only SBEs. Adolescents reporting loss of control episodes had greater dysfunction in some components of the MetS compared to youth without loss of control; episode size may contribute to metabolic dysfunction. Published by Elsevier Ltd.
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    • "s presence of LOC eating . LOC eating was de - fined as a subjective experience of lack of control during reported con - sumption of ambiguously and / or unambiguously large amounts of food . The Eating Disorder Examination has demonstrated excellent inter - rater reliability and discriminant validity for assessing LOC epi - sodes in adolescents ( Glasofer et al . , 2007 ) . Participants who reported one or more LOC episode in the month prior to assessment were includ - ed in the LOC group ( LOC+ ) ; all others were included in the non - LOC ( LOC− ) group ."
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    ABSTRACT: The interpersonal model of loss of control (LOC) eating proposes that socially distressing situations lead to anxious states that trigger excessive food consumption. Self-reports support these links, but the neurobiological underpinnings of these relationships remain unclear. We therefore examined brain regions associated with anxiety in relation to LOC eating and energy intake in the laboratory. Twenty-two overweight and obese (BMIz: 1.9±0.4) adolescent (15.8±1.6y) girls with LOC eating (LOC+, n=10) and without LOC eating (LOC-, n=12) underwent functional magnetic resonance imaging (fMRI) during a simulated peer interaction chatroom paradigm. Immediately after the fMRI scan, girls consumed lunch ad libitum from a 10,934-kcal laboratory buffet meal with the instruction to "let yourself go and eat as much as you want." Pre-specified hypotheses regarding activation of five regions of interest were tested. Analysis of fMRI data revealed a significant group by peer feedback interaction in the ventromedial prefrontal cortex (vmPFC), such that LOC+ had less activity following peer rejection (vs. acceptance), while LOC- had increased activity (p<.005). Moreover, functional coupling between vmPFC and striatum for peer rejection (vs. acceptance) interacted with LOC status: coupling was positive for LOC+, but negative in LOC- (p<.005). Activity of fusiform face area (FFA) during negative peer feedback from high-value peers also interacted with LOC status (p<.005). A positive association between FFA activation and intake during the meal was observed among only those with LOC eating. In conclusion, overweight and obese girls with LOC eating may be distinguished by a failure to engage regions of prefrontal cortex implicated in emotion regulation in response to social distress. The relationship between FFA activation and food intake supports the notion that heightened sensitivity to incoming interpersonal cues and perturbations in socio-emotional neural circuits may lead to overeating in order to cope with negative affect elicited by social discomfort in susceptible youth. Published by Elsevier Inc.
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    • "Both the adult and child versions measure the same constructs and have been successfully combined in previous studies (e.g. Glasofer et al., 2007; Tanofsky-Kraff et al., 2009) and have shown excellent inter-rater reliability (Glasofer et al., 2007; Tanofsky-Kraff et al., 2004). LOC eating was deemed present if youth endorsed at least one objective binge episode (defined as consuming an objectively large amount of food while experiencing a lack of control over eating) or subjective binge episode (defined as consuming an ambiguously large amount of food while experiencing a lack of control over eating) within the past 28 days. "
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