Do Psychogenic Dysphagia Patients Have an Eating Disorder?

Patients who report dysphagia, but have no detectable physical defect, have often been diagnosed as having an eating disorder. This diagnosis was evaluated by administering the Eating Disorders Inventory-2 (EDI-2) and a measure of distress, the Symptom Checklist-90 (SCL-90R), to a sample of 21 adult psychogenic dysphagia patients (PDPs). Their EDI-2 responses were then compared with samples of anorexics, college men, and college women, and their SCL-90R responses were compared with published data of patients with dysphagia due to a motility disorder, an obstruction, or neither. Relative to the anorexics, the PDPs scored significantly lower on all EDI-2 dimensions except maturity fears. For the SCL-90R, PDPs scored significantly higher on the interpersonal sensitivity, depression, anxiety, and general severity index than did the dysphagia comparison groups. Moreover, PDP scores on the anxiety and interpersonal sensitivity dimensions were indicative of clinically significant distress. These findings suggest that PDPs do not appear to have an eating disorder, but that they report clinically significant levels of psychological distress, particularly anxiety.     

Binge Eating and Temperament in Morbidly Obese Prebariatric Surgery Patients

The objective of this study was to investigate the relationship between binge eating and temperament variables, controlling for depression and adult attention deficit/hyperactivity disorder (ADHD), in 90 extremely obese individuals. The participants completed questionnaires assessing eating pathology, reactive temperament, effortful control, depression and ADHD and were grouped based on the presence of regular binge eating. Patients reporting regular binge eating did not differ from patients not reporting regular binge eating with respect to BMI, age, gender, the occurrence of adult ADHD and reactive temperament. However, individuals with binge eating exhibited more pathological scores with regard to eating pathology, depression and effortful control. A logistic regression analysis revealed that only eating concerns and reduced effortful control remained significantly associated with regular binge eating. Binge eating in morbidly obese individuals appears to be associated with a lack of effortful control. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.     

Stressful Life Events and Binge Eating Disorder

Although there is evidence about the role played by stressful life events (SE) in the pathogenesis of eating disorders, few studies to date have explored this problem in binge eating disorder (BED). The aim of the present study was to examine SE preceding the onset of BED. A retrospective interview‐based design was used to compare 107 patients with BED and 107 patients with bulimia nervosa (BN), matched for duration of illness. Compared with patients with BN, those with BED reported a greater number of traumatic events in the 6 months preceding onset, revealing more often three types of events: bereavement, separation from a family member and accidents. The presence of SE before onset showed a dose–response relationship with the severity of psychopathology at the time of referral for treatment. Study of SE in patients with BED may be important for better understanding of the pathogenetic pathway to this disorder and to provide adequate treatment. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.     

Binge Eating,Binge Eating Disorder and Loss of Control Eating: Effects on Weight Outcomes after Bariatric Surgery

There is increasing evidence that patients who have problems with binge eating (BE) or BE disorder (BED) are quite common among the severely obese, including bariatric surgery candidates. The literature suggests that in many cases such eating behaviours improve after bariatric surgery, although this is not uniformly true. The current paper reviews the data on the development of BE, BED and loss of control (LOC) eating after bariatric surgery and the impact of these problems on long‐term weight outcome. A search was made of various databases regarding evidence of BE, BED and LOC eating post‐operatively in bariatric surgery patients. The data extracted from the literature suggests that 15 research studies have now examined this question. Fourteen of the available 15 studies suggest that the development of problems with BE, BED or LOC eating post‐bariatric surgery is associated with less weight loss and/or more weight regain post‐bariatric surgery. These data suggests that it is important to identify individuals at high risk for these problems, to follow them post‐operatively, and, if appropriate interventions can be developed if such behaviours occur in order to maximize weight loss outcomes. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.     

Sex Differences and Correlates of Pain in Patients with Comorbid Obesity and Binge Eating Disorder

Sex differences and correlates of pain were examined in a sample of patients with comorbid binge eating disorder (BED) and obesity. One hundred fifty‐two treatment‐seeking patients with BED completed the Brief Pain Inventory. Analysis of covariance was utilized to compare women and men on pain, and correlational analysis, overall and by sex, was performed to examine relationships among pain, eating behaviour and metabolic risk factors. Women reported significantly greater pain severity and pain interference than men. Among women, eating behaviour and metabolic markers were not associated with pain. Among men, however, binge frequency was significantly associated with pain, as was high‐density lipoprotein cholesterol and fasting glucose. In sum, while women in this sample had more pain than men, the presence of pain in men was associated with increased behavioural and metabolic risk factors. Findings have clinical implications for the assessment of comorbid pain and obesity‐related health risks among individuals with BED. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.     

Factor Structure of the Binge Eating Scale in a Large Sample of Obese and Overweight Patients Attending Low Energy Diet Therapy

In the present study, we evaluated the dimensionality and psychometric properties of the Italian version of the Binge Eating Scale (BES) in a 669 (127 men and 542 women) obese and overweight patients seeking weight loss treatment. All participants were administered the Italian version of the BES. Fit statistics for the alternative SEM models demonstrated that both the one‐factor and competing two‐factor models had a comparable fit to the data. Thus, we selected the one‐factor model as the most parsimonious. The BES had good internal consistency reliability (α = 0.89) with a moderate mean inter‐item correlation (r_ii = 0.34). Given that we were not able to clearly determine the best model among the competing two‐factor models and a comparable fit of these models with the one‐factor model, we have suggested that the one‐factor model is the best fitting model describing the dimensionality of the BES. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.     

Effects of Rumination and Acceptance on Body Dissatisfaction in Binge Eating Disorder

Overvaluation of shape and weight and the corresponding body dissatisfaction are a maintenance factor for the psychopathology of binge eating disorder (BED). Evidence suggests potential benefits of various emotion regulation (ER) strategies in the modification of body dissatisfaction. Therefore, in the present study body dissatisfaction was experimentally induced in women with BED (n = 30) using model pictures. Then, participants were instructed to either ruminate on present emotions and thoughts or accept whatever thoughts and feelings come up. Body dissatisfaction and mood were assessed prior to, immediately after and 4 minutes after the induction. Main results reveal that ER strategies had no differential impact on body dissatisfaction. However, in the rumination condition mood significantly worsened over time. Overall, the results suggest that ER strategies have a limited impact on the experience of body dissatisfaction in BED. However, having an impact on mood, they may be important with regard to the maintenance of pathological eating behaviour in BED. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.     

Aortomesenteric Fat Thickness With Ultrasound Predicts Metabolic Diseases in Obese Patients

BackgroundThe relation between visceral fat accumulation and development of cardiovascular and metabolic disorders has been demonstrated. The aim of this study was to determine the relationship between a new ultrasound visceral fat thickness (vFT) measurement and clinical and anthropometric data in a consecutive series of obese patients.MethodsFifty-five consecutive male obese patients underwent ultrasound evaluation and metabolic and anthropometric parameters determination at baseline and after 3 weeks of a very low–calorie diet (VLCD) therapy. The new ultrasound measurement, the thickness of the fat between the aorta and the superior mesenteric artery (AMFT), was determined along with the maximum thickness of preperitoneal fat and the global VFT.ResultsAMFT showed a better correlation than VFT and preperitoneal fat with all anthropometric and metabolic parameters, both at baseline and after VLCD regimen. At baseline, patients in the middle and high AMFT and VFT tertiles had a significantly higher prevalence of metabolic diseases with respect to AMFT and VFT low tertile patients, whereas after VLCD period, AMFT only showed significant difference within tertiles. The odds ratios for the various metabolic diseases were higher in the middle and high AMFT tertiles than those in the middle and high VFT tertiles, remaining significant after adjustment for age, body mass index and VLCD regimen only in the middle and high AMFT tertiles.ConclusionsThe ultrasonographic AMFT evaluation is strongly correlated to the presence of metabolic syndrome and could be a valuable tool to predict metabolic diseases and associated cardiovascular risks in men.     

Delay Discounting of Reward and Impulsivity in Eating Disorders: From Anorexia Nervosa to Binge Eating Disorder

Evidence points to eating disorder patients displaying altered rates of delay discounting (one's degree of preference for immediate rewards over larger delayed rewards). Anorexia nervosa (AN) patients are believed to have an increased capacity to delay reward, which reflects their ability to override the drive to eat. Contrarily, binge eating disorder (BED) patients are associated with a reduced predisposition to delay gratification. Here, we investigated monetary delay discounting and impulsivity in 80 adult women with EDs (56 AN and 24 BED), diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, and 80 healthy controls. AN‐restrictive (AN‐R) subtype patients showed less steep discounting rates than BED and AN‐bingeing/purging subtype patients. Compared with healthy controls and AN‐R patients, BED and AN‐bingeing/purging patients presented higher delay discounting and positive and negative urgency levels. Our findings suggest that restriction in AN‐R patients is associated with disproportionate self‐control, whereas bingeing behaviours could be more driven by emotional states and impulsivity traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.     

Food‐related impulsivity in obesity and Binge Eating Disorder – a systematic review

Impulsivity towards food has been recognized as a potential factor leading to increased food intake in obesity. Patients suffering from binge eating disorder (BED) form a specific subgroup of obese people that might be characterized by increased impulsivity. These assumptions, although, have yet to be verified. Therefore, this review evaluates evidence for food‐related impulsivity in obese people with and without BED and examines possible differences between both populations. More precisely, evidence for the two components of impulsivity is analyzed separately: evidence for reward sensitivity, specifically, the urge for appetitive stimuli and evidence for rash‐spontaneous behaviour such as acting disinhibited with no regard for the consequences. Our search resulted in 51 articles demonstrating generally increased food‐related impulsivity. We found particular emphasis on increased reward sensitivity in obese people, which appeared to be more pronounced in people with BED. There was little and conflicting evidence, however, concerning increased rash‐spontaneous behaviour in obese people without BED, but consistent evidence of an increase in obese people with BED. All in all, the evidence supports the view that BED represents a specific phenotype of obesity with increased food‐related impulsivity. Taking these specific deficits into account can enhance the effectiveness of weight reduction programmes and psychotherapy.     

Avoidant Restrictive Food Intake Disorder Prevalent Among Patients With Inflammatory Bowel Disease

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An Examination of Adults on Antipsychotic Medication at Risk for Metabolic Syndrome: A Comparison with Obese and Eating Disorder Populations

Little research has explored how eating disorders (ED) may be involved in the increased risk for metabolic syndrome in adults on antipsychotic medication. This pilot study compared participants on antipsychotic medication with obese and ED samples with respect to demographic and psychosocial factors. Participants (antipsychotic medication n = 12; obese n = 12; ED n = 12), were adults presenting to an outpatient psychiatry department (83.3% women; M age = 45.75 ± 11.5). Analysis of variance, analysis of covariance and chi‐square tests were used to compare the samples. Participants on antipsychotic medications had a significantly lower mean body mass index than the obese (p < .001) and ED (p < .05) samples, as well as significantly lower Restraint Total scores (p < .05) and subjective binge episode frequency (p < .05) than the ED sample. The lack of significant differences that occurred between the antipsychotic medication sample and two eating disorder samples significantly different from one another indicates that this population may have unique symptomology and treatment needs. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.     

The Prevalence of Binge Eating Disorder in a Sample of College Students in the North of Portugal

Binge eating disorder (BED) has important associated comorbidities and has been recently considered as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition. This study investigates the prevalence of BED in a sample of college students using a two‐stage design. Between October 2008 and July 2009, 805 students attending a public college campus completed the Questionnaire on Eating and Weight Patterns – Revised to screen for possible cases. Eighty‐five students meeting key criteria for BED were invited for a second stage interview using the Eating Disorder Examination. At stage 1, 9.6% of the subjects reported binge eating episodes. At stage 2, a prevalence rate of 0.5% for BED was found, and 1% if the criterion for large amount of food was excluded. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.