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PubMed1996

Binge eating disorder and the night-eating syndrome.

OBJECTIVE: To determine in three samples of obese women the prevalence of two eating disorders--binge eating disorder and the night-eating syndrome. METHOD: Interviews utilizing standard criteria. For binge eating disorder: the consumption of large amounts of food in a discrete period of time together with a subjective sense of loss of control and no vomiting or laxative abuse. For the night-eating syndrome: morning anorexia, evening hyperphagia and insomnia. Determining the rate of binging among patients receiving a placebo. SUBJECTS: (1) 102 viewers of a television show describing binge eating disorder; (2) 50 participants in a trial of medication for this disorder and (3) 79 participants in a weight reduction program. RESULTS: In the television sample 19.6% of respondents and in the weight reduction sample 7.6% met criteria for binge eating disorder; all subjects in the medication sample met criteria. During a 4-week placebo period average binge frequency fell from 6.0 to 1.7 binges per week. The night-eating syndrome was manifested by 13.7% of the television sample, 8.9% of the weight reduction sample and 15.0% in the medication trial sample. There was little overlap between the two disorders. CONCLUSIONS: Binge eating disorder is far less frequent than has been believed on the basis of questionnaire studies and it is highly responsive to placebos. Frequency of the night-eating syndrome is comparable to that of binge eating disorder. Future studies should assess binge eating disorder by interview rather than by self-administered questionnaire.

Adult↗
PubMed2004

Which factors do provoke binge eating? An exploratory study in eating disorder patients.

OBJECTIVE: To study the different factors (external, emotional, cognitive, and physiological) which may trigger binge eating in eating disorder patients and to make a comparison of binge eating triggers in different eating disorder samples, i.e. anorexia nervosa bingeing-purging type and bulimia nervosa (BN). METHOD: A total of 242 eating disorder patients filled out the Binge Eating Trigger Checklist (BETCH), a new screening device to evaluate the type of situations (and their experienced discomfort) which subjects identify as antecedents of a binge eating episode. RESULTS: Eating disorder patients report a combination of negative emotions, physiological states (urge for sweets) and negative cognitions as most important antecedents for their bingeing episodes. External stimuli were only reported by a small number of patients and provoked significantly lower levels of discomfort. A comparison of binge eating triggers in bingeing anorexia nervosa patients and bulimic patients showed only a few significant differences. CONCLUSIONS: Binge eating, as perceived and reported by eating disorder patients, seems to be provoked by a combination of different antecedents, both emotional, cognitive and physiological. Remarkably enough, binge eating triggers did not differ between bingeing anorectic patients and patients suffering from BN.

Adult↗
PubMed2006

The relationship between restrained eating and poor psychological health is moderated by pleasure normally associated with eating.

This study investigated the relationship between restrained eating and poor psychological health, and the importance of pleasure normally associated with eating in this relationship. Pleasure normally associated with eating, restrained eating, and anxiety, depression and satisfaction with life were assessed concurrently by questionnaire. A relationship between restrained eating and poor psychological health was found--greater restrained eating was significantly independently associated with greater anxiety (B=1.099, p<0.01). Furthermore, pleasure associated with eating was an important moderator in this relationship--greater pleasure associated with eating combined with greater restrained eating was also significantly independently associated with greater anxiety (B=1.067, p=0.02). No effects were found for depression or satisfaction with life. These findings suggest that the pleasure normally associated with eating is important in the relationship between restrained eating and poor psychological health. Subsidiary exploratory analyses also suggest that the relationship between restrained eating and poor psychological health, and the importance of pleasure in that relationship, may differ in males and females.

Adolescent↗
PubMed2006

Changes in eating behaviour following group therapy for women who binge eat: a pilot study.

Survey research is demonstrating that binge eating and compulsive eating may be a significant problem in the obese population. There is higher incidence of binge eating among women, associated with subjective distress and poor prognosis for weight control. Despite attendant health risks, researched clinical responses have not been developed. A before and after uncontrolled pilot study aimed to evaluate the effectiveness of group therapy for women who binge eat and compulsively eat. Participants attended a weekly integrative therapy group for 6 months. Measurements before and after the group intervention were taken using the Binge Eating Scale and Clinical Outcomes in Routine Evaluation inventories. Before and after interviews were thematically analysed for changes in eating behaviour. Following the group intervention, all participants demonstrated changes in eating behaviour measured by the Binge Eating Scale, the overall effect from baseline to 1 year demonstrates statistical significance. Qualitative data revealed four categories that underpinned reduction in binge eating: changes in dichotomous thinking, awareness of eating behaviour, detachment from food and dietary changes. An integrative model of group therapy warrants further research and refinement for this population, a group protocol for nurses working in the field of obesity and eating disorders could be developed.

Adult↗
PubMed2005

Plasma ghrelin in anorexia, bulimia, and binge-eating disorder: relations with eating patterns and circulating concentrations of cortisol and thyroid hormones.

The present study was designed to investigate the relations between plasma ghrelin concentrations, eating patterns, and circulating concentrations of cortisol and thyroid hormones in women with anorexia nervosa, bulimia nervosa, and binge-eating disorder. The patterns of disordered eating behavior were assessed using the Eating Attitudes Test (EAT-26) and the Bulimia Test-Revised (BULIT-R). In women with eating disorders, but not in healthy control women, plasma ghrelin concentrations were negatively correlated with body mass index (BMI) and plasma concentrations of thyreotropin (TSH), free T3 and free T4, and positively correlated with plasma concentrations of cortisol. The ghrelin concentrations of women with binge-eating and purging behavior were significantly lower than those of women with anorexia nervosa, restricting type, and there was a negative relation between the frequency and severity of binge-eating and purging behavior, as measured by the BULIT-R total score, and ghrelin concentrations. In a multivariate regression model controlling for the confounding effects of body mass index (BMI) and age, higher ghrelin concentrations were correlated with lower BULIT-R total scores. The results of this study did not confirm the hypothesis advanced in previous studies that ghrelin concentrations are higher in patients with binge-eating/purging forms of eating disorders. Based on these data, we suggest that, in women with eating disorders, ghrelin concentrations best reflect nutritional status rather than specific patterns of disordered eating behavior.

Adult↗
PubMed2005

Eating disorders and disordered eating among patients seeking non-surgical weight-loss treatment in Sweden.

The aim of this cross-sectional descriptive study of 194 Swedish men and women seeking non-surgical weight-loss treatment was to investigate the presence of eating disorders and binge eating symptoms and to compare these two groups of patients with a group without eating disorder- or binge eating symptoms. The groups were compared in regard to co-morbid psychopathology, Health Related Quality of Life (HRQL) and anthropometric data. Of the total sample, 9.8% fulfilled criteria for any eating disorder. An additional 7.2% indicated binge eating symptoms without having an eating disorder. The three groups were significantly different in regard to psychopathology scales and most HRQL items. Eating disorders and binge eating symptoms are common among patients seeking non-surgical weight-loss treatments in Sweden and both groups showed elevated levels of co-morbid psychopathology and lower HRQL compared to patients without disordered eating. These findings point to the importance of assessing the full range of eating disorder symptoms and disorders as well as HRQL and co-morbid psychopathology before weight-loss treatment, as these factors might affect treatment outcome.

Adult↗
PubMed2005

The relationship between eating self-efficacy and eating disorder symptoms in a non-clinical sample.

Most research on eating self-efficacy has focused on its relationship with eating behaviors and weight-loss in clinical populations. The purpose of this study was to investigate the relationship between eating self-efficacy and the behavioral and psychological characteristics associated with eating disorders in a non-clinical sample of adults. A total of 219 men and women aged 18 and older completed questionnaires measuring eating disorder symptoms and eating self-efficacy. The results indicated that low confidence in the ability to control eating while experiencing negative emotions was associated with greater weight preoccupation and bulimic thought and behaviors. In addition, low confidence in ability to control eating when an abundance of food is available was inversely related to feelings of ineffectiveness or general negative self-evaluation. Ultimately, the findings suggest that low eating self-efficacy may also be associated with eating problems within populations not seeking treatment for either eating disorders or weight-loss. The implications of the findings are discussed.

Adolescent↗
PubMedDate not supplied

The evaluation of eating and weight symptoms. A comparison of medically ill and eating disorder patients.

The purpose of this study was to determine the utility of hospitalization in a medical-psychiatry unit for eating disorder patients. A retrospective chart review of 48 patients given an International Classification of Disease-9 diagnosis of an eating disorder was conducted. Presenting symptoms, functional status using the Karnofsky Index, medical and psychiatric evaluation, diagnosis, treatment, and outcome were evaluated. Patients fell into 1 of 3 groups: those with an active eating disorder and comorbid medical complications (Eating Disorder [ED] positive [POS], n = 25), those with a history of an eating disorder admitted for some other reason (ED history [HX], n = 8), and those with eating or weight symptoms ultimately found to be related to a noneating disorder or primary medical process (ED negative [NEG], n = 15). The ED POS patients were younger (28.1 vs. 49.1 years, P = 0.0001) but had a lower functional status on admission compared with the ED NEG patients (Karnofsky score 51 vs. 72, P = 0.0002). They were more likely to binge eat, restrain intake, and abuse laxatives (P = 0.0001, P = 0.024, P = 0.037, respectively) but did not differ with respect to history of vomiting (P = 0.113). The ED POS patients were more likely to be transferred to a general psychiatry or eating disorder unit. Overall length of stay was greater in this group (44.6 vs. 20.4 days, P = 0.031). Initial evaluation of patients presenting with eating or weight symptoms may be difficult given similarities between the patients with primary eating disorders and those with other underlying medical causes. The medical-psychiatry unit provides comprehensive initial evaluation and treatment of patients with eating and weight symptoms.

Adolescent↗
PubMed2000

On the relation of attempting to lose weight, restraint, and binge eating in outpatients with binge eating disorder.

OBJECTIVE: To examine the relationship among attempts to lose weight, restraint, and eating behavior in outpatients with binge eating disorder (BED). RESEARCH METHODS AND PROCEDURES: Participants were 93 consecutive outpatients evaluated for a clinical trial who met Diagnostic and Statistical Manual, Fourth edition criteria for BED. The Eating Disorder Examination Interview was administered to assess attempts at weight loss, restraint, different forms of overeating, and the attitudinal psychopathology of eating disorders (i.e., concerns regarding eating, shape, and weight). In addition, the Three-Factor Eating Questionnaire was used to assess cognitive restraint, hunger, and disinhibition. Psychometrically established measures were given to assess body dissatisfaction, depression, and self-esteem. RESULTS: The majority of participants (75.3%; N = 70) reported attempting to lose weight, but only 37.6% (N = 35) reported dietary restraint on at least half the days of the month. Dietary restraint and cognitive restraint were not associated with any form of binge eating or overeating. Dietary restraint and cognitive restraint were positively correlated with weight concern, shape concern, and body dissatisfaction, and negatively correlated with body mass index. To further examine the interplay between attempting to lose weight and restraint, three study groups were created: unrestrained nonattempters (21.5%, N = 20), unrestrained attempters (40.9%; N = 38), and restrained attempters (34.4%; N = 32). The three groups did not differ significantly on binge eating or other eating behaviors; however, significant differences were observed for weight concern, shape concern, and body dissatisfaction. DISCUSSION: Attempts to lose weight and restraint are not synonymous for patients with BED. Although 75.3% of BED patients reported that they were attempting to lose weight, only 37.6% reported dietary restraint on at least half the days of the previous month. While restraint was negatively associated with body mass index, it was not related to binge eating or overeating. Our findings raise questions about prevailing models that posit restraint as a predominant factor in the maintenance of binge eating in BED.

Adult↗
PubMed2006

Eating habits and attitudes among 10-year-old children of mothers with eating disorders: longitudinal study.

BACKGROUND: Children of mothers with eating disorders are at increased risk of developmental disturbance, but there has been little research in middle childhood, when disturbed eating habits tend to emerge. AIMS: To examine whether maternal eating disorders identified in the postnatal year are associated with the development of disturbed eating habits and attitudes in children at 10 years of age. METHOD: Follow-up comparative study of 56 families (33 mothers with eating disorders and 23 controls). Psychopathology of children, mothers and fathers was assessed by interview, and mother-child interaction observed. RESULTS: The index group of children scored higher than controls on three of four domains of eating disorder psychopathology and on a global score. Children's eating disturbance was associated with length of exposure to mothers' eating disorder and mother-child mealtime conflict at 5 years. There was some evidence of increased emotional problems in index children. CONCLUSIONS: The children of mothers with eating disorders manifested disturbed eating habits and attitudes compared with controls, and may be at heightened risk of developing frank eating disorder psychopathology.

Adult↗
PubMed2000

The Eating Attitudes Test: validation with DSM-IV eating disorder criteria.

The Eating Attitudes Test (EAT; Garner & Garfinkel, 1979) is one of the most widely used self-report eating disorder instruments. Originally developed to diagnose anorexia nervosa, it is often used in nonclinical samples where it has a high false-positive rate, which is likely due to changes in diagnostic criteria. Because the EAT has not been validated with Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) criteria, we examined its criterion validity for discriminating between nonclinical women with and without an undifferentiated DSM-IV eating disorder diagnosis. We also examined differences in mean EAT scores among eating-disordered, symptomatic, and asymptomatic participants. Results show that the EAT has an accuracy rate of at least 90% when used to differentially diagnose those with and without eating disorders and that mean EAT scores differed among eating-disordered, symptomatic, and asymptomatic participants.

Adolescent↗
PubMed2003

Binge eating and binge eating disorder in a small-scale, indigenous society: the view from Fiji.

OBJECTIVE: Although the cross-cultural prevalence of anorexia and bulimia nervosa has been investigated in multiple studies, little is known about the prevalence and correlates of binge eating and binge eating disorder (BED) cross-culturally. No published studies to date have explored BED in small-scale, indigenous, or developing societies. The current study investigated the prevalence and correlates of binge eating in a community sample of Fijian women living in rural Fiji. METHODS: Fifty ethnic Fijian women completed a self-report measure developed for this study on dieting and attitudes toward body shape and change, a Nadroga-language questionnaire on body image, and the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R). Their height and weight were also measured. Patterns of dieting, high body mass index (BMI), and attitudes toward eating and body image were compared between women with and without a history of binge eating. RESULTS: Ten percent of respondents reported at least weekly episodes of binge eating during the past 6 months and 4% endorsed symptoms consistent with BED. Binge eating in this sample was associated significantly with a BMI value above 35, a history of dieting, and a high concern with body shape. Binge eating was not associated with several markers of acculturation in this sample, although it was associated with a key, nontraditionally Fijian (i.e., acculturated) attitude toward the body. DISCUSSION: Binge eating occurred in a social context with traditions concerning weight and diet widely disparate from Western populations. However, correlates of binge eating in this sample suggest that nontraditional Fijian attitudes toward weight and body shape play a contributory role.

Adolescent↗
PubMed1993

Use of eating-pattern messages to evaluate changes in eating behaviors in a worksite cholesterol education program.

OBJECTIVE: To determine whether eating-pattern messages can effectively be used in a worksite cholesterol education program to change eating behaviors. SUBJECTS: 91 randomly selected participants with initial serum cholesterol levels of 5.2 mmol/L attended the program. INTERVENTION: Eating-pattern messages were the focus of a successful 8-week worksite cholesterol education program conducted with city employees of Phoenix, Ariz. Participants completed self-administered questionnaires before and after the intervention that asked them to compare their current eating patterns with those addressed in the program. The majority (n = 84) of the participants attended five or more of eight available sessions, led by registered dietitians, which focused on the skills needed to decrease dietary fat. STATISTICAL ANALYSES PERFORMED: Parametric and nonparametric statistical tests were used to evaluate the direction and magnitude of changes in eating patterns. RESULTS: Participants made statistically significant changes in 11 of 15 eating patterns linked to messages delivered during the intervention. Changes in eating behaviors were related to improvements in blood lipid profiles. Results from a multiple regression analysis indicated that intervention-related changes in total cholesterol were significantly associated with combined eating-pattern message scores, and total cholesterol decreased 0.33 mmol/L for each unit decrease in the combined eating-pattern message score. APPLICATIONS/CONCLUSIONS: These findings indicate that eating-pattern messages can be used successfully to evaluate changes in fat-related eating behaviors.

Arizona↗
PubMed1996

Abnormalities in weight status, eating attitudes, and eating behaviors among urban high school students: correlations with self-esteem and anxiety.

PURPOSE: The study's objective was to determine the prevalence of abnormalities in weight, eating attitudes, and eating behaviors among an urban teenage population. METHODS: Measures of weight, height, and blood pressure were obtained from 1,001 students attending regularly scheduled physical education classes in a New York City high school the population of which was 66% black and 23% Hispanic. The mean age was 16 years old; 55% were female and 45% were male. Approximately three quarters of the students completed the Eating Attitudes Test (EAT-26), Rosenberg Self-Esteem Scale, Spielberger Trait Anxiety Inventory, and a questionnaire on eating behaviors. RESULTS: By percent ideal body weight (%IBW), 25% of students were obese (>20% above IBW), 18% were overweight, and 5% were underweight. Abnormal EAT scores (>21), were found in 6% of males and 15% of females. Students reported that they had engaged in the following nutritional behaviors at least three times in the past week: eating candy (59%), skipping breakfast (58%), skipping lunch (42%), eating fast foods (28%), and skipping dinner (14%). Self-esteem was high in 60%, medium in 21%, and low in 19%. Mean self-esteem was significantly higher (P < .0001) than established norms. Self-esteem and anxiety were inversely correlated (r = .40, P < .001), and low self-esteem and high anxiety were both associated with high EAT scores (r = .29, P < .001). Self-esteem and anxiety of obese students did not differ from those who were of normal weight. CONCLUSIONS: Among this population of urban high school students there were: (a) a large number of overweight adolescents; (b) a significant subgroup with eating attitudes suggestive of an eating disorder; and (c) high levels of self-esteem and normal levels of anxiety, which were independent of weight status.

Adolescent↗
PubMed2000

Fish intake and blood lipids in fish eating vs non-fish eating communities of coastal south India.

The lower blood lipid levels and lower incidence of coronary heart disease in fish eating populations has been attributed to the unusual n-3 fatty acids present in their fish diet. In order to test this hypothesis, a cross-sectional study was proposed to evaluate the lipid profile in free-living men and women of fish eating and non-fish eating populations aged between 20 to 70 years in coastal villages of the district of Nellore, in south India. The mean concentrations of total serum cholesterol and triacylglycerols were found to be lower in fish eating than in non-fish eating populations. Significant differences were observed between populations for certain age groups. The serum phospholipid content was lower in fish-eating than non-fish eating populations and the difference was found to be significant only for women. The mean total cholesterol and triacylglycerol levels were found elevated consistently as the age advanced in both sexes and populations. There were significant differences for blood lipids between men and women in some age groups. The percentile cut-off values for cholesterol and triacylglycerol were lower in fish eating as compared to non-fish eating group. Prevalence of hypercholesterolemia and hypertriglyceridemia (> or = 200 mg/dl) was significantly lower in fish eating people indicating less proneness to cardiovascular risk. The data indicate that eating of fish may have a role in ameliorating the risk of coronary heart disease.

Adult↗
PubMed2000

Effects of eating space and availability of water in feeders on productivity and eating behavior of grower/finisher pigs.

Three experiments were conducted to determine the effects of eating space and availability of water within feeders on the productivity and behavior of growing/finishing pigs. In Exp. 1, 12 commercial feeders were classified as being either single-space (SS) or multiple-space (MS), and either as dry (D) or wet/dry (WD), resulting in two SS-D, four MS-D, three SS-WD and three MS-WD models. Each model was evaluated using four pens of 12 pigs, which were fed a mash diet throughout the growing/finishing period (25 to 106 kg). Pigs were videotaped when they were approximately 40 and 80 kg in weight to determine eating behavior. The number of feeding spaces did not affect the productivity of the pigs, but the presence of water within the feeder resulted in increases in ADFI (P < .05) and ADG (P < .05) and a reduction in carcass lean (P < .05). Pigs eating from SS feeders spent 15% less time eating than those fed from two-space feeders (P < .05), and occupancy rate for feeding spaces was increased by 75% (P < .05). The WD feeders also resulted in a reduction (17%) in eatingtime compared to D models (P < .01), and occupancy rate for WD feeders was similarly reduced (P < .05). Pigs spent 16% less time eating when they weighed approximately 80 kg than when they weighed 40 kg (P < .01). In Exp. 2, rate of eating was determined during a short test on the same 12 feeder models for both small (48 kg) and large (90 kg) pigs. Large pigs ate faster than small pigs, but eating rate was not affected by feeding space or presence of water in the feeder. In Exp. 3, eating rate was determined for small amounts of dry or wet feed. Premixing water with the feed (1:1 ratio by weight) increased eating speed (P < .01). We concluded that 12 pigs can be fed from a single-space feeder without affecting productivity. The inclusion of water within a feeder decreases time spent eating, but it increases ADFI and ADG. When pigs are small, they spend more time eating, and feeder occupancy rates are higher than when they are large.

Animal Husbandry↗
PubMed2001

Dysfunctional eating in the eating disorders.

Aberrant eating patterns in the eating disorders have been observed across various laboratory-based and clinical studies. It is now clear that problems in experiencing and expressing hunger, appetite, and satiety in anorexia and bulimia nervosa are likely to perpetuate the disorders once established. Whether problems in appetite regulation are primary or secondary to the development of the disorders is unknown. In studies examining indices of appetite regulation after treatment, there still remain significant levels of eating abnormality. This suggests that the main goals of treatment, including restoration of body weight in anorexia nervosa, abstaining from dieting in anorexia or bulimia nervosa, and reducing or abstaining from binge eating, do not correct some features of abnormal eating. The efficacy of nutritional counseling and specific nutritional management programs have been tested, and these seem to produce positive outcomes in improving eating behavior. Direct behavioral interventions to change eating patterns also have been examined, and these too seem to produce benefits that may be incorporated into CBT. Greater collaboration and cooperation between researchers and clinicians in addressing dysfunctional eating in the eating disorders will highlight improvements in treatment for identifiable eating abnormalities and will further the understanding of the human appetite system.

Cues↗
PubMed1999

Emotional eating and eating psychopathology in nonclinical groups: a cross-cultural comparison of women in Japan and the United Kingdom.

OBJECTIVE: Emotional eating is associated with eating psychopathology among Western populations. It is not known whether the same conclusions hold in non-Western cultures, where norms for emotional expression differ. This study examined whether emotional eating has the same eating psychopathology correlates in different cultures. METHOD: Three groups of nonclinical women were compared-Japanese living in Japan; Japanese living in the United Kingdom; and British living in the United Kingdom. They completed an Emotional Eating Scale and the Eating Disorders Inventory. RESULTS: There were different patterns of association between emotional eating and eating attitudes in the three groups. British women showed a strong linkage, Japanese women living in Japan showed no association, and Japanese women in the United Kingdom showed an intermediate pattern. CONCLUSIONS: Emotional eating may be less of an index of eating psychopathology in non-Western cultures. However, there appears to be an acculturative process, linking the two when one enters a Western culture. This cross-cultural difference may have implications for the targeting of therapies, although this conclusion requires support from further research.

Adolescent↗