Increased Depressive-like, Anxiety-like, and Perseverative-like Behavior in Binge Eating Model in Juvenile Rats.

The aim of the present study was to evaluate depressive-like, anxiety-like, and perseverative-like behaviors in a binge eating model. Juvenile Wistar rats, using the binge eating model, were compared to caloric restriction, induced stress, and control groups. Rats of the induced stress group presented binge-like behaviors in standard food intake in the second cycle of the experiment when compared to the caloric restriction group and the binge eating model group. Depressive-like behavior was observed in the binge eating model group with longer immobility time (p < 0.001) and less swim time (p < 0.001) in comparison to the control group. Anxiety-like behavior was observed by shorter duration of burying latency in the binge eating model group when compared to the induced stress group (p = 0.04) and a longer duration of burying time when compared to the control group (p = 0.02). We observed perseverative-like behavior by the binge model group, who made more entries to the new arm (p = 0.0004) and spent a longer time in the new arm when compared to the control group (p = 0.0001). Our results show differences in behaviors between the groups of rats studied. These results suggest that calorie restriction-refeeding, along with stress, may lead to depressive-like, anxiety-like, and perseverative-like behavioral changes in male Wistar rats.

Eating disorder symptom dimensions and protective factors: A structural network analysis study.

Eating Disorders (EDs) and related symptoms pose a substantial public health concern due to their widespread prevalence among both genders and associated negative outcomes, underscoring the need for effective preventive interventions. In this context, deepening our understanding of the interplay between ED symptoms and related protective factors appears crucial. Therefore, this study employed a structural network analysis approach considering both ED symptom dimensions (i.e., drive for thinness, bulimic symptoms, and body dissatisfaction) and related protective factors (i.e., body and functionality appreciation, intuitive eating, and self-esteem) to shed light on how these factors are interrelated. A community sample of 1391 individuals (34.4% men; Mage = 26.4 years) completed a socio-demographic schedule and self-report questionnaires. The network showed that the nodes with the highest positive expected influence were body and functionality appreciation, while those with the highest negative expected influence were eating for physical rather than emotional reasons and unconditional permission to eat (i.e., two components of intuitive eating). Crucially, the most relevant bridges between the conceptual communities "ED symptom dimensions" and "Protective factors" were the negative relations between (a) eating for physical rather than emotional reasons and bulimic symptoms, (b) unconditional permission to eat and drive for thinness, and (c) body appreciation and body dissatisfaction. Finally, age, gender, and body mass index did not moderate any edge in the network. The practical implications of these findings are discussed, especially in terms of preventive interventions for ED symptoms.

Profiles of disordered eating behaviour in type 1 diabetes using the DEPS-R and behaviour and glycaemic outcomes in a real-life setting.

AIMS: The Diabetes Eating Problems Survey - Revised (DEPS-R) is commonly used to assess disordered eating behaviour (DEB) in individuals with type 1 diabetes and has advantages compared to other measures not specifically tailored to diabetes. A score ≥20 on the DEPS-R is used to indicate clinically significant DEB; however, it does not distinguish between eating disorder (ED) phenotypes necessary to guide treatment decisions, limiting clinical utility. METHODS: The current study used latent class analysis to identify distinct person-centred profiles of DEB in adults with type 1 diabetes using the DEPS-R. Analysis of Variance with Games Howell post-hoc comparisons was then conducted to examine the correspondence between the profiles and binge eating, insulin restriction and glycaemic control (HbA1c, mean blood glucose, and percent time spent in hyperglycaemia) during 3 days of assessment in a real-life setting. RESULTS: Latent class analysis indicated a 4-class solution, with patterns of item endorsement suggesting the following profiles: Bulimia, Binge Eating, Overeating and Low Pathology. Differences in binge eating, insulin restriction and glycaemic control were observed between profiles during 3 days of at-home assessment. The Bulimia profile was associated with highest HbA1c and 3-day mean blood glucose. CONCLUSIONS: There are common patterns of responses on the DEPS-R that appear to reflect different ED phenotypes. Profiles based on the DEPS-R corresponded with behaviour in the real-life setting as expected and were associated with different glycaemic outcomes. Results may have implications for the use of the DEPS-R in research and clinical settings.

Effects of Mindful Eating in Patients with Obesity and Binge Eating Disorder.

INTRODUCTION: Binge eating disorder (BED) is a psychiatric illness related to a high frequency of episodes of binge eating, loss of control, body image dissatisfaction, and suffering caused by overeating. It is estimated that 30% of patients with BED are affected by obesity. "Mindful eating" (ME) is a promising new eating technique that can improve self-control and good food choices, helping to increase awareness about the triggers of binge eating episodes and intuitive eating training. OBJECTIVES: To analyze the impact of ME on episodes of binge eating, body image dissatisfaction, quality of life, eating habits, and anthropometric data [weight, Body Mass Index (BMI), and waist circumference] in patients with obesity and BED. METHOD: This quantitative, prospective, longitudinal, and experimental study recruited 82 patients diagnosed with obesity and BED. The intervention was divided into eight individual weekly meetings, guided by ME sessions, nutritional educational dynamics, cooking workshops, food sensory analyses, and applications of questionnaires [Body Shape Questionnaire (BSQ); Binge Eating Scale (BES); Quality of Life Scale (WHOQOL-BREF)]. There was no dietary prescription for calories, carbohydrates, proteins, fats, and fiber. Patients were only encouraged to consume fewer ultra-processed foods and more natural and minimally processed foods. The meetings occurred from October to November 2023. STATISTICAL ANALYSIS: To carry out inferential statistics, the Shapiro-Wilk test was used to verify the normality of variable distribution. All variables were identified as non-normal distribution and were compared between the first and the eighth week using a two-tailed Wilcoxon test. Non-Gaussian data were represented by median ± interquartile range (IQR). Additionally, α < 0.05 and p < 0.05 were adopted. RESULTS: Significant reductions were found from the first to the eighth week for weight, BMI, waist circumference, episodes of binge eating, BSQ scale score, BES score, and total energy value (all p < 0.0001). In contrast, there was a significant increase in the WHOQOL-BREF score and daily water intake (p < 0.0001). CONCLUSIONS: ME improved anthropometric data, episodes of binge eating, body image dissatisfaction, eating habits, and quality of life in participants with obesity and BED in the short-term. However, an extension of the project will be necessary to analyze the impact of the intervention in the long-term.

Influence of mental and behavioral factors on weight loss after bariatric surgery: A systematic review and meta-analysis.

INTRODUCTION: Multiple factors are related to lower weight loss after bariatric surgery. This review and meta-analysis evaluates the influence of several mental and behavioral factors on weight loss. METHOD: Six electronic databases were searched. Percentage excess weight loss (%EWL) was calculated for all moderator and non-moderator groups of the variables: symptoms of depression, anxiety and binge eating, compliance, physical activity, quality of life, and body image. All moderators, surgery types, and follow-up moments were analyzed separately. RESULTS: In total, 75 articles were included in the review; 12 meta-analyses were conducted. Higher postoperative compliance to follow-up was associated with 6.86%-13.68% higher EWL. Preoperative binge eating was related to more weight loss at 24- and 36-month follow-up (7.97% and 11.79%EWL, respectively). Patients with postoperative binge eating symptoms had an 11.92% lower EWL. Patients with preoperative depressive symptoms lost equal weight compared to patients without symptoms. CONCLUSION: Despite the high heterogeneity between studies, a trend emerges suggesting that the presence of postoperative binge eating symptoms and lower postoperative compliance may be associated with less weight loss after bariatric-metabolic surgery. Additionally, preoperative depressive symptoms and binge eating do not seem to significantly impact weight loss.

Momentary appearance focused self-concept is associated with dietary restraint and binge eating in female university students: An experience sampling study.

OBJECTIVE: Appearance focused self-concept (i.e., overvaluing the importance of appearance for self-definition and self-worth) is theorized to predict dietary restraint and binge eating in the short-term (e.g., daily life). Yet, no research has examined whether appearance focused self-concept increases within-persons during a day and if such increases are linked to greater dietary restraint and binge eating for that day. We addressed this gap in knowledge. METHOD: Sixty-three female university students completed four items from the Beliefs About Appearance Scale as a measure of appearance focused self-concept six times per day (9 am, 11 am, 1 pm, 3 pm, 5 pm, and 7 pm) for 14 days. Daily at 9 pm, they completed measures of dietary restraint and binge eating for that day. RESULTS: Analyzing data from 555 days, latent growth curve analyses revealed a small-to-moderate linear increase in appearance focused self-concept from 9 am to 3 pm that plateaued from 3 to 7 pm. A more rapid linear increase in appearance focused self-concept from 9 am to 3 pm was associated with greater binge-eating frequency during that day, but not with dietary restraint. The findings were observed when adjusting for between-day appearance focused self-concept at 9 am, which was positively associated with dietary restraint and binge-eating frequency. DISCUSSION: Findings are discussed in relation to research on appearance focused self-concept as a risk factor for disordered eating. Findings are also discussed in relation to how sociocultural factors may increase appearance focused self-concept over time. Future research should delve into the within-day dynamic interplay between appearance focused self-concept and disordered eating. PUBLIC SIGNIFICANCE: Our study revealed a noteworthy increase in the importance women attach to their appearance over the course of a day, correlating with increased binge eating during that day. Additionally, heightened appearance importance at the onset of a day was associated with more dietary restraint and binge eating during that day. These findings suggest a shorter timescale for the connection between appearance importance and disordered eating than previously understood.

Affect trajectories surrounding binge eating episodes and heavy drinking episodes in adults with binge-spectrum eating disorders.

OBJECTIVE: The comorbidity of binge eating and heavy drinking (BE + HD) is concerning due to high prevalence and associated consequences. Affective pathways may maintain BE + HD, yet more micro-level research is needed. This study used ecological momentary assessment (EMA) to examine between-person and day-level relationships between positive and negative affect and binge eating or heavy drinking episodes in BE + HD. METHODS: Participants (N = 53) were adults with binge-spectrum eating disorders who completed between 7 and 14 days of EMA prior to a treatment for binge eating. RESULTS: Anxiety was highest on days with both binge eating and heavy drinking, while excitement and confidence were highest on days with only heavy drinking episodes for BE + HD. Global negative affect was relatively stable surrounding binge eating episodes. Guilt significantly increased prior to binge eating, and sadness significantly decreased following binge eating. Global positive affect significantly decreased prior to and stopped decreasing following heavy drinking episodes. DISCUSSION: Results support binge eating being negatively reinforced by specific aspects of negative affect, while heavy drinking may be positively reinforced by global positive affect for individuals with BE + HD. Clinicians should incorporate interventions that focus on specific negative affect dimensions and that promote alternative rewarding activities besides heavy drinking.

Inflammatory profiles in women with eating disorder: Linking inflammatory biomarkers to clinical phenotypes.

INTRODUCTION: Eating disorders (ED) represent a group of very complex and serious diagnoses characterized by emotional dysregulation and impulsivity. New approaches are necessary to achieve effective diagnosis and treatments. Shifting biomarker research away from the constraints of diagnostic categories may effectively contribute to a dimensional differentiation across disorders according to neurobiology (e.g., inflammatory biomarkers). Thus, the aim of our study was to identify inflammatory profiles in patients with ED. METHODS: A sample of 100 women with an ED (23.4 ± 8.55 years) and 59 healthy controls (HC) (20.22 ± 4.18 years) was used. K-means cluster analysis was followed to identify inflammatory clusters considering seven blood biomarkers (iNOS, TNFα, COX2, p38, ERK, TBARS and PPARγ). Moreover, a wide assessment of clinical features was conducted. RESULTS: Two distinct clusters were identified. Cluster 1 patients were characterized by higher inflammatory levels of TNF-α, COX2, p38, and ERK, and had more restrictive anorexia diagnosis than cluster 2. Cluster 2 participants showed higher inflammatory levels of iNOS and were older than cluster 1 and controls and had lower BMI than HC. In addition, they had higher levels of bulimic symptoms than those from the cluster 1 and HC, and higher impulsivity than HC. All ED patients (regardless of cluster) showed higher ED symptoms and more trauma than HC. CONCLUSIONS: Our study revealed that inflammatory dysfunction may be linked with clinical endophenotypes in ED, one more restrictive (cluster 1) with an inflammation/oxidative endophenotype more cytokine and MAPK/ERK mediated, and the other more impulsive, with more bulimic symptoms (cluster 2) with NO free radical high output source iNOS. Trauma seems to be a vulnerability factor for both endophenotypes.

Clarifying the pathway from anxiety sensitivity to binge eating: The mediating role of depressive symptoms in a 3-week, 3-wave longitudinal study of undergraduates.

Anxiety sensitivity (AS) - characterized by a persistent fear that arousal-related bodily sensations will lead to serious cognitive, physical, and/or social consequences - is associated with various psychopathologies, including depressive symptoms and binge eating. This 3-week, 3-wave longitudinal study examined the relation between AS (including its global AS factor and lower-order AS cognitive, physical, and social concern dimensions), depressive symptoms, and binge eating among 410 undergraduates from two universities. Using generalized estimating equation models, we found that global AS, AS social concerns, and depressive symptoms predicted binge eating during any given week. Mediation analyses showed that global AS (as a latent variable with its lower-order AS dimensions as indicators), AS cognitive concerns, and AS physical concerns at Wave 1 predicted subsequent increases in depressive symptoms at Wave 2, which, in turn, led to increases in binge eating at Wave 3. Findings contribute to a better understanding of the interplay between AS, depressive symptoms, and binge eating, highlighting the role of binge eating as a potential coping mechanism for individuals with high AS, particularly in managing depressive symptoms. This study underscores the importance of AS-targeted intervention and prevention efforts in addressing depressive symptoms and binge eating.

"I Haven't Told Anyone but You": Experiences and Biopsychosocial Support Needs of People With Type 2 Diabetes and Binge Eating.

Up to 25% of people with type 2 diabetes (T2D) may binge eat which is almost 10 times as many as in the general population. Binge eating is associated with depression, anxiety, and social isolation. Moreover, binge eating may increase the risk of obesity and high blood glucose levels, both of which can accelerate the onset of complications to diabetes and death in people with T2D. Still, little is known about the experiences, needs, and preferences of people with T2D and binge eating that can inform and develop current and future treatment efforts. The aim of the study was therefore to gain in-depth insights into the experiences and biopsychosocial support needs of women and men with T2D and binge eating. Twenty semi-structured individual interviews (65% with females) were conducted and analyzed according to the methodology of Interpretive Description. Four themes were identified: (a) T2D and binge eating: Feeling trapped in a vicious circle; (b) Unwanted outcasts: Responding to continuous criticism; (c) Biomedical relief: Blaming and adjusting the body; and, (d) Silent struggles: Wanting to cease the secrecy. Pertinent to all themes were the guilt, shame, and worries about developing complications that the participants experienced when binge eating despite having T2D. Although binge eating triggered emotional distress, binge eating was at the same time a way of coping with such distress. Implications for treatment and future research are discussed, including the need to systematically assess and address binge eating in routine T2D care.

Prospective associations between cognitive flexibility and eating disorder symptoms in anorexia nervosa and bulimia nervosa.

This study investigated concurrent and prospective associations between measures of reversal learning and attentional set-shifting and eating disorder symptoms at baseline, 3 months, and 6 months among individuals with anorexia nervosa restricting subtype (AN-R, n = 26), AN binge eating/purging subtype (AN-BP, n = 22), bulimia nervosa (BN, n = 35), and healthy controls (n = 27), and explored whether these associations differed by diagnosis. At baseline, participants completed diagnostic interviews, height/weight measurements, and measures of set-shifting (the Intradimensional/Extradimensional shift task) and reversal learning (a probabilistic reversal learning task). At 3- and 6-month follow-up, participants with eating disorders completed assessments of weight and eating disorder symptoms. A one-way analysis of variance found no evidence that baseline reversal learning and attentional set-shifting differed across diagnostic groups. Multilevel modeling analyses indicated that perseverative errors (an index of reversal learning) predicted an increase in purging over time for individuals with AN-BP and BN. Set-shifting errors differentially predicted frequency of loss of control eating for individuals with AN-BP and BN; however, set-shifting was not related to loss of control eating when examined separately in AN-BP and BN. These findings suggest that disentangling facets of cognitive flexibility may help understand change in eating disorder symptoms.

Longitudinal associations between adolescent skin color satisfaction and adult health outcomes in Black women.

OBJECTIVE: Although emerging studies examine the inverse relationship between body satisfaction and disordered eating for Black women, it has not been established how racially salient aspects of body satisfaction may have implications for eating behaviors and longitudinal health outcomes. METHOD: In a longitudinal sample of 455 Black women, we examined whether skin color satisfaction across ages 10-15 was directly related to adult health outcomes at age 40 (e.g., disordered eating, self-esteem, self-reported health, depressive symptoms, and cardiovascular risk). We also investigated the indirect impact of skin color satisfaction on adult health, mediated by body satisfaction, and binge eating. RESULTS: No significant direct or indirect effects of adolescent skin color satisfaction were observed for depressive symptoms or cardiovascular health outcomes. At ages 10 and 12, skin color satisfaction had negative and positive direct effects, respectively, on self-esteem. At age 15, greater skin color satisfaction was directly associated with greater self-reported health. Post hoc analyses revealed that when additionally accounting for adolescent body satisfaction, greater skin color satisfaction was indirectly associated with greater self-esteem and self-reported health, alongside lower cardiovascular risk. CONCLUSIONS: Although previous research suggests that in adolescence, Black girls' skin color satisfaction affects both body satisfaction and disordered eating behaviors, this association does not hold into midlife. Rather, post hoc analyses suggest that the lasting effects of adolescent skin color satisfaction are mediated by the longitudinal stability of body satisfaction, which in turn, is associated with adult health outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

'It is not a mannequin disease': A lived experience narrative of living with bulimia nervosa.

WHAT IS KNOWN ON THE SUBJECT?: Bulimia nervosa is characterized by recurrent episodes of binge eating, inappropriate compensatory behaviours to prevent weight gain and excessive mental preoccupation with body weight and shape. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: In this paper, the feelings, thoughts and experiences of an individual with bulimia nervosa are explained, and the positive and negative effects of their experiences during the treatment process are emphasized. This paper offers advice to patients, relatives and healthcare professionals in recognizing and treating bulimia nervosa. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses should organize training, seminars and conferences to raise awareness of society against bulimia nervosa, which is defined as a mannequin disease and therefore creates a positive perception. Mental health nurses, an essential part of the health system, should raise awareness of individuals and families about recognizing, monitoring and supporting the early symptoms of bulimia nervosa. ABSTRACT: INTRODUCTION: Bulimia nervosa is one of the areas where mental health professionals have difficulties due to its nature and course. It is important to understand the factors related to this problem in-depth to discover the dynamics unique to the individual that causes the difficulty, identify new perspectives on these dynamics and identify alternative behaviours, stop stubborn binge-eating attacks and prevent relapse. AIM: It is aimed to provide an in-depth insight into the nature, course and treatment processes of bulimia nervosa through the narrative of the lived experience of an individual living with this problem. IMPLICATION FOR PRACTICE: The perception of beauty seriously impacts the onset and later course of bulimia nervosa and draws attention to the fact that mental health professionals and media workers have important duties to change the concept of beauty equals being skinny, created in society and the media. Quality of perceived social support is very important in preventing, treating and rehabilitating bulimia nervosa. Adopting a more objective approach, which will prevent the positive or negative stigmatization of the disease in explaining bulimia nervosa to the public, should be adopted.

Not niche: eating disorders as an example in the dangers of overspecialisation.

Labelling specific psychiatric concerns as 'niche' topics relegated to specialty journals obstructs high-quality research and clinical care for these issues. Despite their severity, eating disorders are under-represented in high-impact journals, underfunded, and under-addressed in psychiatric training. We provide recommendations to stimulate broad knowledge dissemination for under-acknowledged, yet severe, psychiatric disorders.

Exploratory study of the prevalence of food addiction and its relationship with executive functioning, depression, and reinforcement sensitivity in a sample of Mexican adults.

Introduction: The study of food addiction (FA) has become relevant due to its high prevalence, the negative impact on quality of life, and its association with neuropsychological and psychiatric symptoms. Several studies have provided scientific support for these associations, however, the results are contradictory. Additionally, studies have unsuccessfully elucidated the true nature of the failures in executive functioning in people with FA symptomatology, particularly when it comes to executive deficits. Therefore, the purpose of this research was to establish whether the presence of executive dysfunction, depressive symptoms and binge eating problems, as well as high reward sensitivity entails a greater severity in FA traits and high body mass index (BMI) in a sample of Mexican adults. Methods: The sample consisted of Mexican men and women between 21-59 years (n = 36); who completed self-report questionnaires and performance tests to measure the study variables. Additionally, BMI was estimated with self-reported height and weight. Results: Our results showed that a high number of FA symptoms were associated with higher executive dysfunction scores, greater reward sensitivity, and more severe depressive and binge eating problems. Furthermore, factors that are more strongly associated with higher scores of FA include severe executive deficits, greater activation of the punishment avoidance system, and persistence in the search for reward when the depressive symptoms increased. The factors that best explained changes in the estimated BMI of women were a decreased crystallized intellectual capacity and the inability to control food intake as the number of FA symptoms increased. Discussion: In summary, the cognitive functioning profile characterized by general failure of the executive functioning, as well as a greater activation of the Punishment Avoidance System and persistence in the search for reward, were associated with greater severity of FA symptoms, especially when the depressive symptomatology was severe. In parallel, the psychopathology in participants associated with FA confirms the contribution of anxious and depressive symptomatology and borderline personality traits which could facilitate the expression of clinically relevant FA symptoms in women. Finally, we found that decreased crystallized intellectual capacity and inability to control food intake were linked to higher BMI when the number of FA symptoms increased.

Diversity of Binge-Eating Disorder Symptoms Is Associated with Anxiety about Getting Fat Rather Than Body Image: A Clinical Study of Women in Poland.

BACKGROUND: Anxiety about gaining weight is strongly related to body image. Evidence indicates that body dissatisfaction is a strong predictor of eating disorder development. Although not included in DSM-V diagnostic criteria, body image dissatisfaction, and concern are clearly relevant also for individuals with binge-eating disorder (BED). Weight gain anxiety is associated with psychopathological behaviors, but existing research in this area is primarily focused on bulimia nervosa and anorexia nervosa. The goal of this present study was to investigate body image and body mass anxiety in people with BED. METHODS: Women diagnosed with BED (n = 105) aged 18 to 66 were surveyed using the questionnaire developed by the authors evaluating the presence of BED symptoms based on DSM-V criteria, and two other instruments: the Body Esteem Scale (BES), and the Body Mass Anxiety Scale (BMAS-20). Statistical analyses were conducted to examine the correlations of BED with body image and body mass anxiety (Pearson's r), to test differences between groups with greater and lesser BED symptom diversity (Student's t-test or the Mann-Whitney U test), and to assess differences among mild-, moderate- and severe-BED groups (ANOVA with a post-hoc test). RESULTS: A medium positive relationship was found between anxiety about getting fat (AGF) and the diversity of BED, measured as the number of BED symptoms. A larger number of BED symptoms was shown to be associated with a higher level of AGF. However, no significant differences in AGF levels were observed among BED-severity groups, specified with the frequency of binge eating episodes. No correlations were found between BED and body image. There were also no significant differences in body image between groups with a larger and a smaller number of BED symptoms. The only significant difference in body image observed among BED-severity groups was the level of weight concern. People with mild BED displayed a higher level of weight concern than those with severe BED. CONCLUSIONS: Women who binge eat experience high levels of AGF. In the present study, AGF was primarily associated with the number of BED symptoms and not the rate of recurrence of binge-eating episodes. The frequency of BED episodes, however, was linked with weight concern. On the other hand, the hypothesized relationship between disturbed body image and BED was not confirmed. The findings indicate that anxiety about getting fat should be viewed as one of the psychological costs incurred by women experiencing BED symptoms, and it should be mentioned in the next DSM version.

Eating disorders among bariatric surgery patients: The chicken or the egg?

ABSTRACT: Postoperative eating behaviors and unhealthy weight control measures are leading causes of bariatric surgery complications. Candidates for bariatric surgery and individuals with eating disorders may share common risk factors, such as a history of dieting, and/or being bullied or teased for their weight. Binge-eating disorder, night eating syndrome, and bulimia nervosa are the most common eating disorders among candidates for bariatric surgery before the operation. Malnutrition, stress, and intense fear of weight gain can lead to the development of an eating disorder after surgery as well. Plugging, grazing, loss of control eating, dumping, and food avoidance are specific disordered behaviors that may present after bariatric surgery. To improve physical and psychological outcomes for individuals under their care, clinicians can screen for these disordered behaviors and distinguish them from a healthy diet and the expected postsurgical course.

Predictors of neurofeedback treatment outcome in binge-eating disorder: An exploratory study.

OBJECTIVE: Knowledge on predictors for treatment response to psychotherapy in binge-eating disorder (BED) is mixed and not yet available for increasingly popular neurofeedback (NF) treatment targeting self-regulation of aberrant brain activity. This study examined eating disorder- and psychopathology-related predictors for NF treatment success in BED. METHOD: Patients with BED (N = 78) were randomized to 12 sessions of real-time functional near-infrared spectroscopy (rtfNIRS)-NF, targeting individual prefrontal cortex signal up-regulation, electroencephalography (EEG)-NF, targeting down-regulation of fronto-central beta activity, or waitlist (WL). The few studies assessing predictors for clinical outcomes after NF and evidenced predictors for psychotherapy guided the selection of baseline eating disorder-related predictors, including objective binge-eating (OBE) frequency, eating disorder psychopathology (EDP), food cravings, and body mass index (BMI), and general psychopathology-related predictors, including depressive and anxiety symptoms, impulsivity, emotion dysregulation, and self-efficacy. These questionnaire-based or objectively assessed (BMI) predictors were regressed on outcomes OBE frequency and EDP as key features of BED at post-treatment (t1) and 6-month follow-up (t2) in preregistered generalized mixed models (https://osf.io/4aktp). RESULTS: Higher EDP, food cravings, and BMI predicted worse outcomes across all groups at t1 and t2. General psychopathology-related predictors did not predict outcomes at t1 and t2. Explorative analyses indicated that lower OBE frequency and higher self-efficacy predicted lower OBE frequency, and lower EDP predicted lower EDP after the waiting period in WL. DISCUSSION: Consistent with findings for psychotherapy, higher eating disorder-related predictors were associated with higher EDP and OBE frequency. The specificity of psychopathological predictors for NF treatment success warrants further examination. PUBLIC SIGNIFICANCE: This exploratory study firstly assessed eating disorder- and psychopathology-related predictors for neurofeedback treatment outcome in binge-eating disorder and overweight. Findings showed an association between higher eating disorder symptoms and worse neurofeedback outcomes, indicating special needs to be considered in neurofeedback treatment for patients with a higher binge-eating disorder symptom burden. In general, outcomes and assignment to neurofeedback treatment may be improved upon consideration of baseline psychological variables.

Reducing binge eating through behavioral-focused versus emotion-focused implementation intentions in patients with binge eating disorder or bulimia nervosa: An experimental approach.

Binge eating disorder (BED) and bulimia nervosa (BN) are characterized by recurrent binge eating, episodes of consuming large amounts of food in a discrete period of time associated with a loss of control. Implementation intentions are explicit if-then plans that engender goal-directed action, and rely less on cognitive control than standard treatment options. In a sample with BED and BN, we compared two implementation intention conditions to a control condition. In the behavior-focused condition, implementation intentions targeted binge eating behaviors. In the emotion-focused condition, implementation intentions targeted negative affect preceding binge eating. In the control condition, only goal intentions were set. Each condition comprised three sessions. Participants kept food diaries for four weeks. Compared to the control condition both implementation intention conditions showed significant and large reductions of binge eating that persisted for six months. Effects did not differ between the behavior-focused and emotion-focused implementation intention conditions. These results demonstrate that three sessions on implementation intention formation can lead to long-term reductions in binge eating in patients with BED or BN. Learning how to form implementation intentions seems a recommendable addition to the current standard treatment. Future research could investigate the added value of fully personalized implementation intentions. CLINICAL TRIAL REGISTRATION NUMBER: NL52600.068.15.

Effect of interpersonal conflicts and the moderating effect of the dispositional need to belong on binge eating.

The dispositional need to belong (dNTB) is a stable desire to connect with others and belong to groups. Recently, it has been stated that dNTB can alter immediate post-interpersonal conflict behavior. Interpersonal conflict stress is one of the triggers of binge eating. An individual's vulnerability to binge eating in response to interpersonal conflicts before it becomes a disorder has not been investigated from the perspective of the interaction between interpersonal conflict and dNTB. We conducted two studies examining the relationships between interpersonal conflicts and dNTB and the frequency of binge eating behavior in daily life. Conflicting predictions have been made about whether people with a high dNTB eat more after interpersonal conflict than those with a low dNTB. In Study 1, 199 university students answered the survey concerning their dNTB and frequency of interpersonal conflict and binge eating. The results revealed that higher dNTB is associated with more frequent binge eating when individuals face interpersonal conflict. In Study 2, 416 adults throughout Japan participated in the same survey; the results replicated those from Study 1. For exploratory purposes, mental health and other eating behaviors (restrained, emotional, and external eating) were measured in Studies 1 and 2, respectively. However, the moderation effects of dNTB on these eating behaviors were not observed. Previous studies suggested that individuals with a low dNTB ate more in response to social exclusion. This might be due to an immediate interpersonal stress reaction to social exclusion. Conversely, this study's results implicate that the modulation effects of dNTB on excessive eating habits are different from those immediately following interpersonal conflict.