Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later?

OBJECTIVE: To determine if adolescents who report dieting and different weight-control behaviors are at increased or decreased risk for gains in body mass index, overweight status, binge eating, extreme weight-control behaviors, and eating disorders 5 years later. DESIGN: Population-based 5-year longitudinal study. PARTICIPANTS: Adolescents (N=2,516) from diverse ethnic and socioeconomic backgrounds who completed Project EAT (Eating Among Teens) surveys in 1999 (Time 1) and 2004 (Time 2). MAIN OUTCOME MEASURES: Weight status, binge eating, extreme weight control, and self-reported eating disorder. STATISTICAL ANALYSIS: Multiple linear and logistic regressions. RESULTS: Adolescents using unhealthful weight-control behaviors at Time 1 increased their body mass index by about 1 unit more than adolescents not using any weight-control behaviors and were at approximately three times greater risk for being overweight at Time 2 (odds ratio [OR]=2.7 for girls; OR=3.2 for boys). Adolescents using unhealthful weight-control behaviors were also at increased risk for binge eating with loss of control (OR=6.4 for girls; OR=5.9 for boys) and for extreme weight-control behaviors such as self-induced vomiting and use of diet pills, laxatives, and diuretics (OR=2.5 for girls; OR=4.8 for boys) 5 years later, compared with adolescents not using any weight-control behaviors. CONCLUSIONS: Dieting and unhealthful weight-control behaviors predict outcomes related to obesity and eating disorders 5 years later. A shift away from dieting and drastic weight-control measures toward the long-term implementation of healthful eating and physical activity behaviors is needed to prevent obesity and eating disorders in adolescents.     

Weight-control behaviors among adolescent girls and boys: implications for dietary intake

OBJECTIVE: To examine associations between healthful and unhealthful weight-control behaviors and dietary intake among adolescents. DESIGN: Cross-sectional survey (Project EAT [Eating Among Teens]).Subjects/Setting The study population included 4144 middle and high school students from Minneapolis/St. Paul public schools from diverse racial and socioeconomic backgrounds.Statistical analyses Dietary intake patterns were compared across adolescent girls and boys reporting unhealthful, only healthful, or no weight-control behaviors in unadjusted analyses and analyses adjusted for sociodemographic factors and energy intake. RESULTS: Among girls, mean intakes differed across weight-control behaviors for all foods and nutrients examined. P values ranged from P=.006 to P<.001. Girls using unhealthful weight-control behaviors had significantly lower intakes of fruit; vegetables; grains; calcium; iron; vitamins A, C, and B-6; folate; and zinc than girls using only healthful weight-control behaviors. Compared with girls reporting no weight-control behaviors, girls using unhealthful weight-control behaviors had lower intakes of grains, calcium, iron, vitamin B-6, folate, and zinc. In contrast to the girls, boys reporting unhealthful weight-control behaviors did not have poorer dietary intakes than boys not using weight-control behaviors or using only healthful behaviors. Among boys, there were no significant differences in mean intakes of vegetables; grains; calcium; iron; vitamins A, C, and B-6; folate; and zinc. Furthermore, boys using unhealthful weight-control behaviors had higher fruit intakes (P=.002) than boys reporting no weight-control behaviors. CONCLUSIONS: Adolescent girls who engage in unhealthful weight-control behaviors are at increased risk for dietary inadequacy. The findings demonstrate a need for interventions to prevent unhealthful weight-control behaviors in adolescent girls, and to promote healthful weight-control behaviors when indicated.     

Appetitive traits and body mass index in Chinese adolescents: An 18-month longitudinal study with latent growth curve analyses

A longitudinal approach with Latent Growth Curve Modeling (LGCM) was adopted to explore the trajectories of appetitive traits corresponding to BMI in Chinese adolescents. Within a large sample of adolescents (N = 2566, 45.9% boys) aged from 11 to 17 years (M = 13.80, SD = 1.56) at the baseline survey, our results indicated that appetitive traits of emotional overeating, food fussiness, and hunger increased significantly over time while enjoyment of food decreased over time. Slowness in eating and satiety responsiveness significantly increased in girls, while emotional undereating significantly decreased in boys. Moreover, the growth parameters of emotional undereating and satiety responsiveness were significantly and negatively related to BMI in girls. Our findings evidence that certain appetitive traits could change over time in adolescence and these changes relate to weight status. Gender differences are suggested in the design of future intervention and treatment of overweight/obesity in Chinese adolescents.     

Factors Associated with Underweight,Overweight, and Eating Disorders in Young Korean Women: A Population-Based Study

Both underweight (UW) and overweight (OW) conditions are problematic in young women. The aim of this study was to examine the factors associated with extreme weight status and eating disorders (EDs) in young Korean women. A total of 808 women (mean age 22.3 ± 3.4 years) participated, including 144 with UW [Body Mass Index (BMI) < 18.5kg/m²], 364 with NW, and 137 with OW or obesity (BMI ≥ 25kg/m²), and 63 patients with anorexia nervosa (AN) and 100 with bulimia nervosa (BN). Participants completed questionnaires regarding nutrients consumed, eating behaviors, health behaviors, body image, and obsessive-compulsive symptoms with face to face interviews. The associations between the status of participants and the data were analyzed with NW group as a reference. OW status was associated with overeating and with frequent eating. UW status was associated with less frequent overeating and with longer sleep duration. AN status was associated with less frequent consumption of alcohol. BN status was associated with a larger discrepancy between the ideal and current body shape. Both OW status and BN were associated with more obsessive-compulsive symptoms. The results suggested that certain dietary, health, and psychological factors are associated with extreme weight conditions and EDs.     

Shared risk and protective factors for overweight and disordered eating in adolescents

BACKGROUND: Weight-related problems, including obesity, eating disorders, and disordered eating, are major public health problems in adolescents. The identification of shared risk and protective factors for these problems can guide the development of relevant interventions to a broad spectrum of weight-related problems. This paper examines the prevalence and co-occurrence of overweight, binge eating, and extreme weight-control behaviors (vomiting, diet pills, laxatives, and diuretics) in adolescents and identifies shared risk and protective factors from within the socioenvironmental, personal, and behavioral domains for these three adverse weight-related outcomes. METHODS: Data were collected at Time 1 (1998-1999) and Time 2 (2003-2004) on 2516 adolescents participating in Project EAT (Eating Among Teens). Data were analyzed in 2006-2007. RESULTS: Weight-related problems were identified in 44% of the female subjects and 29% of the male subjects. About 40% of overweight girls and 20% of overweight boys engaged in at least one of the disordered eating behaviors (binge eating and/or extreme weight control). Weight-teasing by family, personal weight concerns, and dieting/unhealthy weight-control behaviors strongly and consistently predicted overweight status, binge eating, and extreme weight-control behaviors after 5 years. Family meals, regular meal patterns, and media exposure to messages about weight loss were also associated with weight-related outcomes, although the strength and consistency of associations differed across outcomes and gender. CONCLUSIONS: Weight-specific socioenvironmental, personal, and behavioral variables are strong and consistent predictors of overweight status, binge eating, and extreme weight-control behaviors later in adolescence. These findings support the need for research to determine if decreasing weight-related social pressures, personal weight concerns, and unhealthy weight-control behaviors can contribute to reductions in obesity in children and adolescents.     

Body dissatisfaction mediates the association between body mass index and risky weight control behaviors among White and Native American adolescent girls

The developmental path leading to eating disorders among adolescent girls often proceeds from increasing body size, to increasing body dissatisfaction, to increasing eating disorder (ED) risk. To determine whether body dissatisfaction (BD) mediates the association between body size and risky weight control behaviors, we examined data from White (n=709) and Native American (n=253) girls, who differ substantially in terms of average body mass and reported weight control behaviors. Measures of BD included weight, shape, and appearance concerns. Measures of ED risk included dieting, exercising to control weight, binge eating, and vomiting. Results showed body dissatisfaction was a highly significant mediator of the relationship between body mass index (BMI) and ED risk for both ethnic groups; although, BD did not mediate the association between BMI and binge eating for either group. BD is apparently an important mediator of the association between body size and some, but not all, risky weight control behaviors.     

全国22个省市26个单位24 013名城市在校少年儿童行为问题调查—独生子女精神卫生问题的调查, 防治和Achenbach′s儿童行为量表中国标准化

目的了解青少年进食障碍症状的流行情况,探索进食障碍症状与其他心理行为问题的关联性。方法采取整群抽样的方法,抽取上海市四所中学1 358名学生及其家长进行问卷调查。采用进食态度量表评估青少年进食障碍症状,多动症筛查量表家长报告版评估青少年的多动症症状,Achenbach儿童行为评估量表评估其他行为问题。采用多元线性回归分析探讨青少年进食障碍症状的相关因素。结果进食障碍症状的检出率为12.81%,其中女生为15.36%,显著高于男生的10.37%(χ²=19.43, P < 0.05)。多因素回归分析显示,青少年性别(b=2.18, P < 0.01)、BMI(b=0.21, P < 0.05)、多动症症状(b=0.14, P < 0.05)、积极/消极情绪性多吃(b=0.33, P < 0.05;b=0.41, P < 0.05)与进食障碍的症状水平显著相关。结论多动症以及情绪性多吃与进食障碍症状水平密切相关,提示对于进食障碍的干预和治疗,可充分考虑心理行为问题。     

Self-image and eating disorder symptoms in normal and clinical adolescents

Eating disorders (ED) are psychiatric disorders of multifactorial origin, predominantly appearing in adolescence. Negative self-image is identified as risk factor, but the association between self-image and ED in adolescents or sex differences regarding such associations remains unclear. The study aimed to investigate the relationship between specific self-image aspects and ED symptoms in normal and clinical adolescents, including sex differences. Participants included 855 ED patients (girls = 813, boys = 42) and 482 normal adolescents (girls = 238, boys = 244), 13–15 years. Stepwise regression demonstrated strong associations between self-image and ED in normal adolescents (girls: R² = .31, boys: R² = .08), and stronger associations in patients (girls: R² = .64, boys: R² = .69). Qualitative sex differences were observed in patients. Connections between specific self-image aspects and ED have implications for clinical management of ED. The strong link between self-image variables and ED symptoms in normal girls, but not boys, is discussed in terms of the continuity–discontinuity hypothesis.     

Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program

BACKGROUND/OBJECTIVESNumerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weight-control efforts, dietary habits, and behavior.SUBJECTS/METHODSA survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs.RESULTSObese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001–0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001–0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001–0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001–0.008).CONCLUSIONSAttending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.     

The associations of sociocultural attitudes towards appearance with body dissatisfaction and eating behaviors in Hong Kong adolescents

ObjectivesWestern culture has great influences on body dissatisfaction and related eating behaviors in adolescents. This study aimed to assess the sociocultural influences on eating attitudes and motivations among Hong Kong Chinese adolescents.MethodsIn 2007, 909 adolescents (mean age = 14.7 years, 55.3% boys) completed a survey with Stunkard's Figure Rating Scale (FRS), Motivation for Eating Scale (MFES), Eating Attitudes Test (EAT), Revised Restraint Scale (RRS), and Sociocultural Attitudes Towards Appearance Scale (SATAQ). In addition, their body mass index (BMI) was objectively measured.ResultsOur results indicated that Hong Kong adolescents, particularly girls exhibited a remarked level of body dissatisfaction, external, emotional, restrained and disordered eating behaviors. Hierarchical regression analyses indicated that age, sex and BMI were the most common contributing factors to individual eating styles. SATAQ significantly accounted for an additional variance of body dissatisfaction (2%), physical eating (2%), external eating (1%), emotional eating (3%), restrained eating (5%), and disordered eating (5%).ConclusionsIn Hong Kong, the sociocultural influences on body image and eating disturbance were supported.     

Disability associated with community cases of commonly occurring eating disorders

OBJECTIVE: To examine disability associated with community cases of the more commonly occurring eating disorders and with particular eating disorder behaviours. METHOD: Self-report questionnaires, which included measures of eating disorder symptoms and impairment in everyday functioning, were completed by 495 female residents of the Australian Capital Territory region aged between 18 and 45 years. A structured interview for the assessment of eating disorders was completed by a subgroup (n = 208) of participants. Discriminant function analysis was used to identify cases of eating disorders in the total sample (n = 495) based on the characteristics of individuals interviewed. Impairment in functioning, as measured by the Medical Outcomes Study Short Form, was compared among eating disorder cases and non-cases, among subgroups of participants engaging in particular eating disorder behaviours, and among community cases of anxiety and affective disorders identified from the Australian National Survey of Mental Health and Well-Being. RESULTS: Community cases of eating disorders (n = 31; 6.3%) were associated with substantial impairment in functioning, comparable with that of community cases of anxiety and affective disorders. Among eating disorder behaviours, the use of extreme weight-control behaviours, in particular self-induced vomiting, was associated with the highest levels of impairment, although the occurrence of regular episodes of overeating was also associated with considerable impairment. CONCLUSIONS: The burden on the community of the more commonly occurring eating disorders may be substantial. Improving women's recognition of the adverse effects of eating disordered-behaviour on functioning, as well as their knowledge of effective treatments, will be important in reducing this burden.     

Atypical eating disorders in young children

Eating disorders are considered rare in young children. However, we have admitted 8 prepubertal patients with atypical eating disorders. The 6 girls and 2 boys were 5-11 years old and had markedly abnormal eating behaviors for periods of 2 months to 10 years. Weights varied from 82% to 108% of desirable body weight. All patients refused to eat normal amounts or types of food and struggled with family and staff about eating and weight gain. Several displayed ritualistic, obsessive behaviors during meals. None had a distorted body image or fear of fatness, and none had anorexia nervosa or bulimia nervosa. Observed symptoms ranged from phobic food aversion with little weight loss or depression to very restrictive diets with bizarre eating behaviors, low weight, and significant depressive symptoms. A wide range of critical familial psychosocial problems was identified. All patients gained weight and demonstrated some improvement in eating behaviors in hospital. However, most children had significant associated psychopathology, which required treatment after discharge. Eating disorders may be more common in children than now believed, may be associated with major family conflict, and may not manifest distorted body image or fear of fatness as cardinal symptoms.     

Disability associated with community cases of commonly occurring eatinq disorders

Objective : To examine disability associated with community cases of the more commonly occurring eating disorders and with particular eating disorder behaviours.
Method : Self-report questionnaires, which included measures of eating disorder symptoms and impairment in everyday functioning, were completed by 495 female residents of the Australian Capital Territory region aged between 18 and 45 years. A structured interview for the assessment of eating disorders was completed by a subgroup (n=208) of participants. Discriminant function analysis was used to identify cases of eating disorders in the total sample (n=495) based on the characteristics of individuals interviewed. Impairment in functioning, as measured by the Medical Outcomes Study Short Form, was compared among eating disorder cases and non-cases, among subgroups of participants engaging in particular eating disorder behaviours, and among community cases of anxiety and affective disorders identified from the Australian National Survey of Mental Health and Well-Being.
Results : Community cases of eating disorders (n=31; 6.3%) were associated with substantial impairment in functioning, comparable with that of community cases of anxiety and affective disorders. Among eating disorder behaviours, the use of extreme weight-control behaviours, in particular self-induced vomiting, was associated with the highest levels of impairment, although the occurrence of regular episodes of overeating was also associated with considerable impairment.
Conclusions : The burden on the community of the more commonly occurring eating disorders may be substantial. Improving women's recognition of the adverse effects of eating disordered-behaviour on functioning, as well as their knowledge of effective treatments, will be important in reducing this burden.     

BMI,weight change,and incidence of disability among Korean adults: A nationwide retrospective cohort study

BackgroundLittle is known about the risk of acquired disability diagnosed by a physician in relation to baseline BMI and weight change, particularly in the Asian population.ObjectiveThis study assessed the association of baseline BMI and weight change with incidence of disability.MethodsThis study included 331,900 individuals aged ≥40 years who participated in two health-screening programs since 2002 or 2003 and who were followed up until 2013. This study measured the baseline BMI and weight change for two years and estimated the adjusted hazard ratio (aHR) of the risk of acquired disability diagnosed by a physician using a Cox proportional hazards model.ResultsThis study identified 1758 incident disability cases during an average follow-up period of 10.7 ± 1.3 years from baseline (9.1 ± 1.4 years from the follow-up health screening). Baseline underweight (BMI<18.5 kg/m²) was associated with an increased risk of acquired disability compared with those with normal BMI (aHR, 1.44; 95% confidence interval [CI], 1.14–1.83). The risk of acquired disability was higher in individuals with weight loss of 5–10% (aHR, 1.21; 95% CI, 1.04–1.40), weight loss of ≥10% (aHR, 1.61; 95% CI, 1.27–2.04), weight gain of 5–10% (aHR, 1.30; 95% CI, 1.12–1.52), or weight gain of ≥10% (aHR, 1.35; 95% CI, 1.09–1.75) compared to those with weight change of <5%.ConclusionThis study demonstrated that baseline underweight and weight changes (both loss and gain) are associated with an increased risk of acquired disability.     

On the relation of flexible and rigid control of eating to body mass index and overeating in patients with binge eating disorder

OBJECTIVE: To examine the relationship of flexible and rigid dimensions of restrained eating to body mass index (BMI) and overeating in outpatients with binge eating disorder (BED). METHOD: Participants were 148 consecutive outpatients who met criteria for BED. The Three-Factor Eating Questionnaire (TFEQ) was administered to assess Cognitive Restraint, Hunger, and Disinhibition. The TFEQ also contains two Cognitive Restraint subscales--Flexible Control and Rigid Control. The Eating Disorder Examination-Questionnaire version (EDE-Q) was administered to assess frequency of different forms of overeating during the past 28 days and the attitudinal features of eating disorders. RESULTS: Flexible Control and Rigid Control were significantly correlated with each other. They were both negatively correlated with BMI, but neither was significantly correlated with the frequency of binge eating or other forms of overeating. In addition, Flexible Control and Rigid Control predicted almost the same amount of variance in BMI. DISCUSSION: BED patients exhibit flexible and rigid control of eating that is related to BMI, but not to the frequency of binge eating or other forms of overeating. Results of the present study provide preliminary evidence that flexible and rigid control of eating may not be a useful distinction in BED patients. However, increased restraint, regardless of type, may prove to be of benefit with regard to weight control and may not have adverse effects on binge eating in obese BED patients.     

Weight-control behaviors among adults and adolescents: associations with dietary intake

BACKGROUND: This study aimed to assess the prevalence of weight-control behaviors and their associations with overall dietary intake among adults and adolescents. METHODS: Participants included 3,832 adults and 459 adolescents from four regions of the United States. Cross-sectional data were collected on energy and nutrient intake, weight-control behaviors, body mass index (BMI), and sociodemographics. RESULTS: Current weight-control behaviors were reported by 52.7% of the study population (adult women, 56.7%; adult men, 50.3%; adolescent girls, 44.0%; adolescent boys, 36.8%). Weight-control behaviors were consistently and positively associated with socioeconomic status among adults, but not among adolescents. Among "dieters," unhealthy practices were reported by 22.7% of adult women, 21.3% of adult men, 30.4% of adolescent girls, and 18.5% of adolescent boys. Adults trying to control their weight reported healthier nutrient intakes than those not trying to control their weight, in particular when moderate weight-control methods were employed. Among adolescents, there were fewer differences across dieting status and these were not suggestive of healthier intakes among dieters than nondieters. CONCLUSIONS: Weight-control behaviors are reported by a large percentage of the population. Weight-control behaviors tend to be healthier among adults than among adolescents, in terms of the types of behaviors used and their impact on nutrient intakes. Obesity prevention interventions should emphasize the importance of using healthy weight-control practices.     

Comparison of the child and parent forms of the Questionnaire on Eating and Weight Patterns in the assessment of children's eating-disordered behaviors

OBJECTIVE: The assessment of eating-disordered behaviors in middle childhood is challenging. Frequently, both child and parents are queried about the child's eating behavior. However, no direct comparisons between parent and child reports of child eating disturbance have been published. We compared results from the adolescent and parent versions of the Questionnaire on Eating and Weight Patterns (QEWP-A and QEWP-P, respectively) in a nontreatment sample of overweight and normal weight children. METHOD: The QEWP-A and QEWP-P were administered to 142 overweight (body mass index [BMI] > or = 85th percentile) and 121 normal weight (BMI 15th-84th percentile) children, age 9.7 +/- 1.9 years, recruited from the community. RESULTS: The QEWP-A and QEWP-P showed good agreement for the absence of eating-disordered behavior but were not concordant in terms of the number or type of binge eating, overeating episodes, or compensatory weight control behaviors in the past 6 months. Children categorized by their own reports (QEWP-A) as engaging in no overeating, simple overeating, or binge eating behaviors did not differ significantly in body composition or in eating and general psychopathology. Children categorized according to their parents' reports (QEWP-P) as engaging in binge eating had significantly greater body adiposity, eating-disordered cognitions, body dissatisfaction, and parent-reported problems (all ps <.001) than children engaging in no overeating or simple overeating according to the QEWP-P. DISCUSSION: Child and parent reports of eating behaviors are not concordant regarding the presence of binge eating or compensatory behaviors. Further investigation of the utility of these questionnaires is needed before either can serve as a surrogate for a clinical interview.     

Accumulated exposure to rural areas of residence over the life course is associated with overweight and obesity in adulthood: a 25-year prospective cohort study

PurposeThis prospective cohort study investigated whether body mass index (BMI) and weight status in mid-adulthood were predicted by trajectories of urban-rural residence from childhood to adulthood.MethodsParticipants aged 7–15 years in 1985 (n = 8498) were followed up in 2004–2006 (n = 3999, aged 26–36 years) and 2009–2011 (n = 3049, aged 31–41 years). Area of residence (AOR) was classified as urban or rural at each time point. BMI and/or weight status was calculated from self-reported weight and height (2009–2011). We tested which of three life-course models (“accumulation,” “sensitive period,” “mobility”) best explained the AOR-BMI and/or weight status association using a novel life-course modeling framework.ResultsAccumulation and sensitive period models best described the effect of AOR on mid-adulthood BMI and weight status. Those with greater accumulated exposure to rural areas had a higher BMI (β = 0.29 kg/m² per time in a rural area, P = .005) and were more likely obese (relative risk = 1.13 per time in a rural area, P = .002). Living in rural areas at ages 26–30 years was also associated with a higher BMI and obesity in mid-adulthood.ConclusionsGreater cumulative exposure to rurality and exposure during the “sensitive period” of young adulthood is associated with obesity in middle-aged adults. This study highlights the important contribution of context to the development of obesity over the life course.     

Too strict or too loose? Perfectionism and impulsivity: The relation with eating disorder symptoms using a person-centered approach

Although both perfectionism (i.e. personal standards perfectionism and evaluative concerns perfectionism) and impulsivity have been shown to be implicated in eating disorders, no previous studies have examined the interplay between both personality dimensions in their association with eating disorder symptoms. This is the first study to investigate the relationship between empirically derived personality subtypes based on perfectionism and impulsivity and eating disorder symptoms (i.e., dietary restraint, and concerns over eating, weight and shape). Cluster analysis was used to establish naturally occurring combinations of perfectionism and impulsivity in adolescent boys and girls (N = 460; M age = 14.2 years, SD = .90). Evidence was obtained for four personality profiles: (1) a resilient subtype (low on perfectionism and impulsivity), (2) pure impulsivity subtype (high on impulsivity only), (3) pure perfectionism subtype (high on perfectionism only), and (4) combined perfectionism/impulsivity subtype (high on both perfectionism and impulsivity). Participants in these four clusters showed differences in terms of eating disorder symptoms in that participants with a combination of high perfectionism and high impulsivity (rather than the presence of one of these two characteristics alone) had the highest levels of ED symptoms. These findings shed new light on extant theories concerning ED.     

Nibbling and picking in obese patients with Binge Eating Disorder

ObjectiveThe goal of this study was to examine the clinical utility of nibbling behavior, defined as eating in an unplanned and repetitious manner between meals and snacks without a sense of loss of control, in obese patients with Binge Eating Disorder (BED).MethodsTwo-hundred seventeen (N = 217) consecutive, treatment-seeking, obese patients with BED were assessed with the Eating Disorder Examination (EDE). Nibbling frequency was examined in relation to current weight, eating disorder psychopathology and eating patterns.ResultsResults found that nibbling/picking was not related to body mass index, objective bulimic, subjective bulimic, or overeating episodes, food avoidance, sensitivity to weight gain, or any subscales of the EDE. However, nibbling/picking was significantly related to frequency of morning and afternoon snacking (r = .21, p = .002; r = .27, p < .001).DiscussionThe assessment of nibbling/picking behaviors among individuals with BED might not provide clinically significant information.