1-Boc-Piperidine-4-Carboxaldehyde Prevents Binge-Eating Behaviour and Anxiety in Rats.

BACKGROUND: Piperidines are biogenic amines studied mainly in toxicology because they were initially found as alkaloids from peppers and insect venoms. Piperidines are also produced in the human body, and their actions seem to be related to wakefulness/sleep and other cognitive phenomena. Piperidines have been minimally characterized for therapeutic applications. In this context, 1-Boc-piperidine-4-carboxaldehyde (1-Boc-piperidine) is a piperidine-derivative molecule with no mechanism of action reported, although its uses include the synthesis of GPR119 selective agonists that have been patented as anti-obesity drugs. OBJECTIVES: The aim of this work was to study the effects of 1-Boc-piperidine on binge-eating behaviour and anxiety in Wistar rats. METHODS: In experimental protocol 1, binge-eating behaviour was induced in animals that received pre-treatment (i.p.) with (i) vehicle (methanol 10%; 1 mL/kg), (ii) 1-Boc-piperidine (1 µmol kg-1), or (iii) 1-Boc-piperidine (10 µmol kg-1). In experimental protocol 2, mildly stressed animals were evaluated in the elevated plus maze under the acute effects of the pre-treatments applied in experimental protocol 1. RESULTS AND CONCLUSIONS: 1-Boc-piperidine decreased, in a dose-dependent manner, the intake of calories from a succulent hyper-caloric food in a binge-eating protocol in female rats, whereas the acute exposition to this piperidine exerted an anxiolytic effect in the male rat. In both effects, the mechanism of action remains to be characterized.

Binge Eating Disorders in Antipsychotic-Treated Patients With Schizophrenia: Prevalence, Antipsychotic Specificities, and Changes Over Time.

BACKGROUND: Excessive energy intake likely favors metabolic dysfunction in patients with schizophrenia and may be, in part, the consequence of antipsychotic treatments. However, previous studies on the prevalence of bulimia and binge eating symptoms in antipsychotic-treated patients are contradictory and not sufficiently informative. METHODS: The prevalence of bulimia nervosa, binge eating disorder, and subsyndromal binge eating disorder was studied using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria in 156 patients with schizophrenia or schizoaffective disorder treated with antipsychotic monotherapy. The effects of different antipsychotics were compared. RESULTS: The prevalence of full syndromal binge eating disorder was 4.4% and that of subsyndromal binge eating disorder was 18.7% in patients (23.1% for binge eating spectrum disorder), and there were no cases of bulimia nervosa. Compared with the whole sample, binge eating spectrum disorders were significantly more prevalent in clozapine- and olanzapine-treated patients. Comparisons of patients having undergone treatment for 2 years or less with patients treated for more than 2 years showed that binge eating spectrum disorders decrease significantly over time, the difference being significant in clozapine- and olanzapine-treated patients. Night eating, simply assessed by a single question, showed a prevalence of 30% and was more prevalent in women treated with clozapine and olanzapine, with no significant change over time. CONCLUSIONS: Binge eating disorders should be considered as important factors involved in the development of weight gain and metabolic syndrome in antipsychotic-treated patients with schizophrenia. The difficulty to reliably assess binge eating spectrum disorders in patients with psychosis is highlighted.

Anorexia nervosa manifesting as massive ascites, hypercholesterolemia, and sequential binge eating in an 11-year-old girl: A case report.

RATIONALE: Anorexia nervosa (AN) is a serious eating disorder associated with a distorted body image. Hypercholesterolemia has been found in patients with AN but the mechanism of hyperlipidemia in AN remains little known. Ascites in patients with AN has been attributed to hypoalbuminemia and liver diseases, but massive ascites without the aforementioned etiologies has never been reported in AN. PATIENT CONCERNS: An 11-year-old girl was admitted for exclusion of organic underlying diseases due to severe body weight loss (18% within 3 weeks), poor appetite, and hypercholesterolemia (274 mg/dL). She complained of heartburn sensation, nausea, vomiting, constipation, and postprandial dull abdominal pain with fullness. DIAGNOSES: The patient's condition met with all 3 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for diagnosing AN. On admission, her total cholesterol level was 337 mg/dL and hypocomplementemia (C3 55.5 mg/dL) was also found. Abdominal sonography and computed tomography scans showed massive ascites. However, neither proteinuria nor hypoalbuminemia was found. Upper gastroduodenal endoscopy showed chronic superficial gastritis and colonoscopy revealed negative findings. Ascites obtained by paracentesis demonstrated a transudate without bacterial infection, tuberculosis, or pancreatitis. Exploratory laparoscopy showed nonpurulent ascites. However, biopsies from the small intestine, mesentery, and liver showed chronic inflammation and fibrosis. INTERVENTIONS: The intensive nutritional therapy by increasing total energy intake stepwise with a combination of high-energy formula and her favorite foods. OUTCOMES: Her hypercholesterolemia, hypocomplementemia, and massive ascites resolved after her weight was restored. She developed binge eating with continuous weight gain after discharge. Her weight significantly increased to an obese level (body mass index [BMI] 25.9 kg/m) after loss to follow-up for 4 years until she returned to our emergency room due to suicide attempt. CONCLUSION: Diagnostic crossover between subtypes in anorexia nervosa might be a potential risk factor for illness severity and poor prognosis. AN can manifest as massive ascites with normal albumin concentrations that could possibly be due to chronic inflammation of the intestinal serosa, mesentery, and peritoneal surface of the liver.

A multi-perspective analysis of dissemination, etiology, clinical view and therapeutic approach for binge eating disorder (BED). / Wieloaspektowa analiza rozpowszechnienia, czynników etiologicznych, obrazu klinicznego i postepowania terapeutycznego zaburzen z napadami objadania (Binge Eating Disorder, BED).

Eating disorders (ED) constitute the third most common group of chronic diseases among people aged 14-19 years after asthma and obesity, and one of their forms is binge eating disorder (BED). The purpose of the present review was to summarize new research findings on BED and overview the epidemiology, characteristics, criteria, etiopathogenesis, and treatment. Etiopathogenesis of BED is still poorly understood, and the current state of knowledge leads to the conclusion that the pathomechanism of the development and persistence of the symptoms of that disorder is very complicated - factors influencing these symptoms have a genetic, neurobiological, biochemical, cognitive, and emotional background. Treatment targeted at selected pathogenetic mechanisms - i.a., disturbance in the corticostriatal circuit, neurohormonal dysregulation or incorrect regulation of emotions - may be of help for people with binge eating disorder. Often comorbid mental, e.g., mood, anxiety and personality disorders, psychoactive substance abuse, suicidal ideation and suicide attempts, and somatic problems are particularly crucial in the context of primary care physicians and psychiatrists work and should encourage the expanding knowledge about BED and the creation of interdisciplinary therapeutic teams.

Does Bariatric Binge-Eating Size Matter? Conceptual Model and Empirical Support.

OBJECTIVE: Bariatric surgery affects the quantity of food individuals can eat, yet some individuals still experience loss of control (LOC) while eating. This cross-sectional study examined a new classification system for binge/LOC eating following bariatric surgery. METHODS: A total of 168 individuals who underwent bariatric surgery 6 months earlier and reported LOC eating were administered the Eating Disorder Examination-Bariatric Surgery Version interview and self-report measures of depressive symptoms, functional impairment, and physical and mental health-related quality of life. Three groups were created based on the largest LOC-eating episode determined by the Eating Disorder Examination-Bariatric Surgery Version interview as follows: (1) "traditional" objective binge-eating episodes, defined as eating unusually large quantities of food while having LOC; (2) "bariatric-objective binge eating," meaning unusually large quantities for postsurgical bariatric patients with LOC; and (3) "bariatric-subjective binge eating," meaning small quantities of food with LOC after surgery. RESULTS: In total, 75% (n = 126) met criteria for the bariatric-objective binge episodes group, 10% (n = 17) met criteria for the traditional objective binge-eating group, and 15% (n = 25) met criteria for the bariatric-subjective binge episodes group. The three groups differed significantly, with a graded pattern by binge size, in global eating-disorder psychopathology, depressive symptoms, and functional impairment but not quality of life. CONCLUSIONS: These findings provide empirical support for a new classification system for bariatric binge/LOC eating. Binge size was associated with distinct psychopathology. Longitudinal follow-up is needed to ascertain effects on clinical outcomes.

Weight suppression increases odds for future onset of anorexia nervosa, bulimia nervosa, and purging disorder, but not binge eating disorder.

BACKGROUND: Eating disorders affect 13% of females and contribute to functional impairment and mortality, but few studies have identified risk factors that prospectively correlate with future onset of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Identifying risk factors specific to each eating disorder is critical for advancing etiologic knowledge and designing effective prevention programs. OBJECTIVES: This study examined whether weight suppression (the difference between a person's highest past weight at their adult height and their current weight) correlates with future onset of AN, BN, BED, and PD. METHODS: Data from 1165 young women with body image concerns (mean ± SD age: 21.9 ± 6.4 y) who completed annual diagnostic interviews over a 3-y follow-up period were examined. Logistic regression models evaluated the relation of baseline weight suppression to onset risk of each eating disorder controlling for age, dietary restraint, and intervention condition. RESULTS: Elevated weight suppression predicted future onset of AN (OR: 1.36; 95% CI: 1.03, 1.80), BN (OR: 1.34; 95% CI: 1.11, 1.62), PD (OR: 1.46; 95% CI: 1.23, 1.74), and any eating disorder (OR: 1.32; 95% CI: 1.12, 1.56), but not BED (OR: 1.10; 95% CI: 0.89, 1.37). Highest past weight correlated with future onset of BN and PD but not onset of AN, BED, or any eating disorder, and baseline current weight was inversely related to future AN onset only, implying that women with the largest difference between their highest past weight and current weight are at greatest risk of eating disorders. CONCLUSIONS: The results provide novel evidence that weight suppression correlates with future onset of eating disorders characterized by dietary restriction or compensatory weight control behaviors and suggest weight-suppressed women constitute an important risk group to target with selective prevention programs.These trials were registered at clinicaltrials.gov as NCT01126918 and NCT01949649.

Mindfulness in Eating Is Inversely Related to Binge Eating and Mood Disturbances in University Students in Health-Related Disciplines.

The purpose of the study was to investigate the relationship between mindful eating, disordered eating and mood in university students in health-related disciplines. A total of 221 university students participated in the study; 102 students studied sport and exercise science (SS), 54 students pharmacy sciences (PS), and 65 students health sciences (HS). Participants completed the Binge Eating Scale (BES), the Mindful Eating Questionnaire (MEQ), and the Profile of Mood State questionnaire (POMS). 41% of the students were classified as binge eaters and 57% were above the POMS threshold of depression. Binge eaters were found to have significantly lower MEQ score and significantly higher total mood disturbance scores (TMD) compared to non-binge eaters (p < 0.01). Students with a high depression score exhibited no differences in the MEQ score but a significantly higher BES score compared to non-depressed students (p < 0.01). Gender differences were found in the MEQ with females exhibiting significantly higher scores in the MEQ score and in all MEQ subscales compared to males, with the exception of the emotional subscale that females were noted to have a lower score compared to males (p < 0.01). The MEQ score was inversely related to the BES score (r = -0.30, p < 0.01) and TMD (r = -0.21, p < 0.05). The MEQ score was a significant negative predictor of the variance of the binge eating behavior of the students (B = -3.17, p < 0.001). In conclusion, mindfulness in eating is inversely related to the binge eating behavior and mood state of university students studying health-related subjects and is a significant negative predictor of disordered eating behavior in this high risk population.

Etiologic and treatment conceptualizations of disordered eating symptoms among mainland Chinese therapists.

OBJECTIVE: Reports of disordered eating are increasing in mainland China; however, little is known regarding Chinese psychotherapists' conceptualizations of disordered eating symptomatology. This study explores Chinese psychotherapists' conceptualizations of binge eating (BE)/vomiting symptoms and treatment considerations. METHOD: In-depth, semi-structured interviews were conducted with mainland Chinese psychotherapists (N = 41) in Mandarin. Participants were given a hypothetical case and provided their conceptualization of the patient's BE/vomiting etiology and treatment recommendations. Etiological conceptualizations were coded using directed content analysis, and treatment recommendations were grouped by intervention strategy. RESULTS: Participants described psychosocial risk factors for BE/vomiting including intrapersonal characteristics and the childhood family environment, but rarely discussed genetic and neurobiological factors. Few participants reported that they would prioritize the BE/vomiting symptoms in treatment and their specific treatment recommendations varied widely. DISCUSSION: Most research on BE/vomiting behaviors in the literature is based on Western samples with little attention to mainland Chinese populations. Participants in this study provided conceptualizations of risk factors and treatment recommendations that could generally find evidence in the existing Western literature, even if some theories are no longer supported by updated Western research and the participants focused primarily on psychosocial risks as opposed to genetic/neurobiological factors. It will be important for future research to ascertain mainland Chinese therapists' understanding of these additional types of risk. These findings also suggest a disconnect between clinical findings on neurobiological risks and Chinese therapists' knowledge and/or perceived clinical utility of these risks. Implications for treatment and research dissemination to diverse global communities are discussed.

Binge-Eating Disorder.

Binge-eating disorder (BED), first included as a diagnostic entity in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, is characterized by recurrent episodes of binge eating without regular compensatory behaviors to prevent weight gain. With a complex multifactorial etiology, BED is the most frequent eating disorder co-occuring with significant psychopathology, mental and physical comorbidity, obesity, and life impairment. Despite its significance, BED is not sufficiently diagnosed or treated. Evidence-based treatments for BED include psychotherapy and structured self-help treatment, with cognitive-behavioral therapy as most well-established approach, and pharmacotherapy with lisdexamfetamine as FDA approved medication with a limitation of use.

A prospective test of the temporal sequencing of risk factor emergence in the dual pathway model of eating disorders.

Prospective studies have identified risk factors that predict future onset of eating disorders, but none has provided a test of the temporal sequencing of the emergence of risk factors hypothesized in a multivariate etiologic model of eating disorder development. Using data from an 8-year prospective study of 496 adolescent girls, we first conducted receiver operator characteristic plots to identify cut-points for each risk factor that optimally predicted future onset of threshold or subthreshold bulimia nervosa, binge eating disorder, and purging disorder. We then used growth curve models to estimate the age at which each participant crossed the disorder-predictive cutpoint for each risk factor, or if they did not, during follow-up, permitting a test of whether the risk factors emerged in the sequence hypothesized in the Dual Pathway etiologic model. Overall, 47% of the 51 youth who showed onset of one of these eating disorders first showed emergence of disorder-predictive levels of perceived pressure to be thin and/or thin-ideal internalization, before showing onset of disorder-predictive levels of body dissatisfaction, before showing onset of disorder-predictive levels of dieting and/or negative affect, before showing onset of the eating disorder; another 29% had one of these steps out of order or did not cross one step in this model. Youth who did not show onset of an eating disorder were significantly less likely to cross the disorder-predictive cut-points for each risk factor or to conform to the sequence of risk factor emergence hypothesized in this model. Results provide novel support for the temporal sequencing of risk factor emergence hypothesized in this multivariate etiologic model and suggest that prevention programs that reduce perceived pressure to be thin and thin-ideal internalization among early adolescent girls with these factors should reduce eating disorder onset, as well as downstream risk factors that are also aversive (e.g., body dissatisfaction and negative affect). (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Which Comes First? An Examination of Associations and Shared Risk Factors for Eating Disorders and Suicidality.

PURPOSE OF REVIEW: This narrative review evaluates recent literature on the associations between eating disorders and suicidality and discusses potential shared mechanisms that may account for these relationships. Additionally, the review highlights shortcomings with the literature to date and suggests avenues for future research. RECENT FINDINGS: Individuals with anorexia nervosa, bulimia nervosa, and binge eating disorder experience elevated rates of suicidality compared to the general population. Suicide risk is higher when eating disorders occur with other psychological conditions. Additionally, genetic factors, emotion dysregulation, trauma, stressful life events, and lack of body regard may have roles in the development of both eating disorders and suicidality. Much of the risk for suicidality in eating disorders appears to be driven by comorbid psychopathology and genetic factors. However, the lack of longitudinal research makes it difficult to draw conclusions about the directionality or temporality of these relations; thus, novel methods are needed.

DEPRESSION, ANXIETY, AND BINGE EATING BEFORE AND AFTER BARIATRIC SURGERY: PROBLEMS THAT REMAIN.

BACKGROUND: As the number of surgeries increases and the elapsed time of the realization increases as well, the postoperative evaluations would become increasingly necessary. AIM: To assess the psychological profile before and after surgery. METHODS: Were evaluated 281 patients from the public service of bariatric surgery. In this study, 109 patients completed the evaluations before surgery (T0) and up to 23 months after surgery (T1); 128 completed the evaluations in T0 and between 24 months and 59 months after surgery (T2); and 44 completed the evaluations in T0 and 60 months after surgery (T3). A semi-structured interview, the Beck Depression Inventory (BDI), Beck Anxiety (BAI), and the Binge Eating Scale (BES) were used. RESULTS: There was a higher prevalence of female (83%), patients with less than 12 years of education (83%), and patients who have a partner (64%). Analyzing all times of evaluation, regarding anxiety, depression, and binge eating, there was a reduction in all symptoms in T1, pointing to significant improvements in the first 23 months after surgery. Already, in T2 and T3, there was an increase in all indicators of anxiety, depression, and binge eating pointing to the transient impact of weight loss or bariatric surgery on these symptoms. CONCLUSIONS: This study shows the importance of the continuous psychological evaluation and needs for the appropriate interventions for these patients who have undergone bariatric surgery, even after weight loss.

Emotional eating and cognitive conflicts as predictors of binge eating disorder in patients with obesity / Alimentación emocional y conflictos cognitivos como predictores del trastorno por atracón en pacientes con obesidad

Background/Objectives: Binge Eating Disorder (BED) is often associated with obesity. In order to identify the variables that allow to better detect the presence of BED, people with overnutrition were compared with and without BED in the presence of cognitive conflicts, eating symptoms and anxious-depressive symptoms. The inclusion of cognitive conflicts had been relevant in bulimia studies but had not been investigated with respect to BED. Method: Two groups with obesity were evaluated, one without BED (OB, n = 54) and the other with BED (OBBED, n = 48), using a social-demographic questionnaire as well as a semi-structured interview to assess BED, questionnaires (DASS-21, EDE-Q, EEQ) and the Repertory Grid Technique. Results: Overall, the OB-BED group presented more conflicts and more symptoms. The model that best differentiated between the groups included emotional eating and level of cognitive conflicts, correctly classifying 91.4% of the sample. Conclusion: These results highlight the role played by cognitive conflicts and emotional eating as differentiating elements between OB and OB-BED, with a high level of predictive accuracy (AU)

Antecedentes/Objetivos: El trastorno por Atracón (TA) es un trastorno de la conducta alimentaria asociado frecuentemente con la obesidad. Con el objetivo de identificar las variables que permiten detectar mejor la presencia de TA se compararon personas con malnutrición por exceso con y sin TA respecto a la presencia de conflictos cognitivos, sintomatología alimentaria y sintomatología ansioso-depresiva. La inclusión de los conflictos cognitivos había resultado relevante en estudios con bulimia pero no habían sido investigados con respecto al TA. Método: Se evaluó a dos grupos con obesidad, uno sin TA (OB, n = 54) y otro con TA (OBTA, n = 48), utilizando un cuestionario sociodemográfico, una entrevista semiestructurada para evaluar TA, cuestionarios (DASS-21, EDE-Q, EEQ) y la Técnica de la Rejilla. Se realizaron análisis de comparación de grupos y de regresión logística. Resultados: El grupo OBTA presentó más conflictos y más sintomatología. El modelo que mejor diferenció entre los grupos incluyó la alimentación emocional y el nivel de conflictos cognitivos, clasificando correctamente al 91,4% de la muestra. Conclusiones: Estos resultados resaltan el rol que juegan los conflictos cognitivos y la alimentación emocional como aspectos diferenciadores entre OB y OBTA, con un alto nivel de precisión predictiva (AU)

Reward sensitivity in Parkinson's patients with binge eating.

BACKGROUND: Parkinson's disease (PD) patients who are treated with dopamine replacement therapy are at risk of developing impulse control disorders (ICDs) (such as gambling, binge eating, and others). According to recent evidence, compulsive reward seeking in ICDs may arise from an excessive attribution of incentive salience (or 'wanting') to rewards. OBJECTIVES: In this study, we tested this hypothesis in patients with PD who developed binge eating (BE). METHODS: Patients with BE, patients without BE, and healthy controls performed different experimental tasks assessing food liking and wanting. Participants first rated the degree of liking and wanting for different foods using explicit self-report measures. They then performed an affective priming task that measured participants' affective reactions towards foods (liking), and a grip-force task that assessed their motivation for food rewards (wanting). All participants also completed several questionnaires assessing impulsivity, reward sensitivity, anxiety and depression, and underwent a neuropsychological evaluation. RESULTS: Patients with BE displayed an altered liking for sweet foods compared to controls but not to patients without BE. Furthermore, this difference emerged only when implicit measures were used. Importantly, an increased wanting was not associated with binge eating even if wanting, but not liking scores significantly correlated with LED levodopa, confirming the hypothesis of a distinction between the two components of rewards. Lastly, binge eating was associated with depression and lower working memory scores. CONCLUSIONS: Take together these results suggest that binge eating in PD is associated with cognitive abnormalities, and to lesser extent affective abnormalities, but not with an increased incentive salience.

The Overlap Between Binge Eating Behaviors and Polycystic Ovarian Syndrome: An Etiological Integrative Model.

Studies indicate that Polycystic Ovarian Syndrome (PCOS) features (e.g. insulin instability, food cravings, overproduction of androgens and menstrual irregularities) are associated with increased appetite, impaired impulse control and feelings of body dissatisfaction. Counter intuitively, binge eating behaviors have been shown to reinforce PCOS symptomatology, precipitating concurrently body dissatisfaction, weight gain, insulin instability and overproduction of androgens. The present systematic literature review aspires to investigate the relationship between binge eating, in the broader context of eating disorder behaviors, and Polycystic Ovarian Syndrome (PCOS), taking into account shared characteristics between EDs (Eating Disorders) and PCOS. To address this aim, the PRISMA guidelines are adopted. A total of 21 studies, which investigated the presence of binge eating in PCOS population and the presence of PCOS in EDs population, were synthesized. Findings suggested that an increased prevalence of binge eating has been reported in women with Polycystic Ovarian Syndrome (PCOS); and that women suffering from BN (Bulimia Nervosa) and BED (Binge Eating Disorder) are more likely to display polycystic ovaries. Further research on their shared liability is required in order to inform more efficient prevention and treatment initiatives for populations presenting with comorbid features.

Depression, anxiety, and binge eating before and after bariatric surgery: problems that remain / Depressão, ansiedade e compulsão alimentar antes e após cirurgia bariátrica: problemas que persistem

ABSTRACT Background: As the number of surgeries increases and the elapsed time of the realization increases as well, the postoperative evaluations would become increasingly necessary. Aim: To assess the psychological profile before and after surgery. Methods: Were evaluated 281 patients from the public service of bariatric surgery. In this study, 109 patients completed the evaluations before surgery (T0) and up to 23 months after surgery (T1); 128 completed the evaluations in T0 and between 24 months and 59 months after surgery (T2); and 44 completed the evaluations in T0 and 60 months after surgery (T3). A semi-structured interview, the Beck Depression Inventory (BDI), Beck Anxiety (BAI), and the Binge Eating Scale (BES) were used. Results: There was a higher prevalence of female (83%), patients with less than 12 years of education (83%), and patients who have a partner (64%). Analyzing all times of evaluation, regarding anxiety, depression, and binge eating, there was a reduction in all symptoms in T1, pointing to significant improvements in the first 23 months after surgery. Already, in T2 and T3, there was an increase in all indicators of anxiety, depression, and binge eating pointing to the transient impact of weight loss or bariatric surgery on these symptoms. Conclusions: This study shows the importance of the continuous psychological evaluation and needs for the appropriate interventions for these patients who have undergone bariatric surgery, even after weight loss.

RESUMO Racional: Avaliações pós-operatórias têm se tornado necessárias em ciruriga bariátrica considerando o grande número de operações e o tempo decorrido de sua realização. Objetivo: Avaliar o perfil psicológico de pacientes de um serviço público de cirurgia bariátrica antes e após o procedimento. Métodos: Foram avaliados no total 281 pacientes. Destes, 109 completaram as avaliações antes (T0) e até 23 meses após a operação (T1); 128 completaram as avaliações em T0 e entre 24 meses e 59 meses após a operação (T2); e 44 completaram as avaliações em T0 e 60 meses após a operação (T3). Foram utilizados entrevista semi-estruturada, Inventário Beck de Depressão (BDI), Inventário Beck de Ansiedade (BAI) e Escala de Compulsção Alimentar Periódica (ECAP). Resultados: Observou-se maior prevalência de mulheres (83%), pacientes com menos de 12 anos de escolaridade (83%) e pacientes que tinham um companheiro(a) (64%). Ao analisar todos os tempos de avaliação, observou-se que, com relação à ansiedade, depressão e compulsão alimentar, houve redução de todos os sintomas em T1, apontando para melhorias significativas nos primeiros 23 meses após a operação. Já em T2 e T3 observou-se aumento de todos os indicadores de ansiedade, depressão e compulsão alimentar, apontando para o impacto transitório da perda de peso alcançada pela cirurgia bariátrica nesses sintomas. Conclusões: Este estudo mostra a importância de avaliações psicológicas contínuas e a necessidade de intervenções multiprofissionais apropriadas para pacientes submetidos à cirurgia bariátrica, mesmo após a perda de peso.

Is laxative misuse associated with binge eating? Examination of laxative misuse among individuals seeking treatment for eating disorders.

OBJECTIVE: Our research focuses on laxative misuse, which has been understudied in previous eating disorders (ED) research, to understand its prevalence and correlates among individuals seeking ED treatment. We also test the association between laxative misuse and binge eating to examine the assumption that laxative misuse is intended to compensate for binge eating. METHOD: Participants were 2,295 ED treatment-seeking adults (29.5 ± 10.5) who self-reported their disordered eating behaviors on the Eating Disorder Questionnaire. Participants met DSM-5 diagnostic criteria for anorexia nervosa (AN: 11.5%, n = 264), bulimia nervosa (BN: 39.0%, n = 896), binge-eating disorder (14.9%, n = 343), or other specified feeding or eating disorder (34.5%, n = 792). RESULTS: Nearly 25% of participants (n = 571) reported misusing laxatives during the last month. Laxative misusers with AN reported significantly higher frequency of laxative misuse relative to misusers with BN (F(1,440) = 5.226, p = .023, ηp2= .012). Among laxative misusers, there was no association between frequency of binge eating and frequency of laxative misuse. DISCUSSION: Laxative misusers with AN tend to misuse laxatives more frequently than those with BN. Binge eating was not related to laxative misuse in our sample. Future research may use real-time data collection to understand the function of laxative misuse and to validate our cross-sectional findings.

Eating disorder-specific risk factors moderate the relationship between negative urgency and binge eating: A behavioral genetic investigation.

Theoretical models of binge eating and eating disorders include both transdiagnostic and eating disorder-specific risk factors. Negative urgency (i.e., the tendency to act impulsively when distressed) is a critical transdiagnostic risk factor for binge eating, but limited research has examined interactions between negative urgency and disorder-specific variables. Investigating these interactions can help identify the circumstances under which negative urgency is most strongly associated with binge eating. We examined whether prominent risk factors (i.e., appearance pressures, thin-ideal internalization, body dissatisfaction, dietary restraint) specified in well-established etiologic models of eating disorders moderate negative urgency-binge eating associations. Further, we investigated whether phenotypic moderation effects were due to genetic and/or environmental associations between negative urgency and binge eating. Participants were 988 female twins aged 11-25 years from the Michigan State University Twin Registry. Appearance pressures, thin-ideal internalization, and body dissatisfaction, but not dietary restraint, significantly moderated negative urgency-binge eating associations, with high levels of these risk factors and high negative urgency associated with the greatest binge eating. Twin moderation models revealed that genetic, but not environmental, sharing between negative urgency and binge eating was enhanced at higher levels of these eating disorder-specific variables. Future longitudinal research should investigate whether eating disorder risk factors shape genetic influences on negative urgency into manifesting as binge eating. (PsycINFO Database Record

Body Esteem as a Common Factor of a Tendency Toward Binge Eating and Sexual Dissatisfaction Among Women: The Role of Dissociation and Stress Response During Sex.

BACKGROUND: Several studies have suggested a relevant overlap between eating disorders and sexual dysfunction involving the emotional component of body image esteem and dissociative experiences. AIM: To evaluate the common maintaining factors of sexual dysfunction and vulnerability to pathologic eating behaviors and their relation to a physiologic stress response. METHODS: In the present cross-sectional study, we evaluated a non-clinical sample of 60 heterosexual women (25-35 years old) for dissociation during sex with a partner, body image disturbance, and tendency toward pathologic eating behaviors. We also evaluated the stress-induced hypothalamic-pituitary-adrenal axis activation in response to a sexual stimulus and its association with binge eating and dissociation. OUTCOMES: Participants completed the Clinician-Administered Dissociative States Scale, the Sexual Satisfaction Scale-Women, the Body Esteem Scale for Adolescents and Adults, and the Eating Attitudes Test Short Version. Furthermore, we assessed cortisol levels before, during, and after exposure to explicit sexual stimuli shown within a laboratory setting. RESULTS: Dysfunctional body image esteem and a tendency toward binge-eating behaviors were associated with greater sexual distress in women. In particular, body esteem was significantly associated with greater dissociation during sex with a partner. Moreover, women who reported greater dissociation during sex with a partner and a tendency toward binge-eating behaviors showed higher levels of cortisol in response to sexual stimuli. CLINICAL IMPLICATIONS: These results support further research based on trans-diagnostic treatments targeted to dissociation and body image esteem, which could lessen sexual dysfunction and vulnerability to pathologic eating behaviors. STRENGTHS AND LIMITATIONS: Despite the small sample and self-reported questionnaires, this is the first study to consider the association of the stress response during sexual stimuli with sexual distress and with pathologic eating behaviors adopting a dimensional approach. CONCLUSION: Body uneasiness and dissociation represented factors underlying pathologic eating behaviors and sexual dysfunction. Women reporting a tendency toward binge-eating episodes and dissociation during sexual experiences represented a subpopulation with a higher stress response during sexual stimuli. Castellini G, Lo Sauro C, Ricca V, Rellini AH. Body Esteem as a Common Factor of a Tendency Toward Binge Eating and Sexual Dissatisfaction Among Women: The Role of Dissociation and Stress Response During Sex. J Sex Med 2017;14:1036-1045.