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3.
Am Psychol ; 75(2): 135-138, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32052989

RESUMO

Approximately 70% of adults in the United States have obesity or are overweight and at risk of developing obesity over time. Obesity is associated with an increased risk of morbidity and mortality; the economic impact of the health care costs associated with obesity is anticipated to have a profound, detrimental effect on the country's economy within the next several decades. A number of psychologists have dedicated their careers to understanding psychosocial and behavioral factors that contribute to weight gain. Others have used psychological theories as the foundation to develop and refine interventions that serve as the cornerstone of most effective approaches to weight loss. Still others have used psychological principles to inform prevention efforts and public policy initiatives believed to be critical to current and future efforts to control the growth of obesity. The articles included in this special issue highlight the substantial contributions that many psychologists have made to the contemporary understanding of the development and treatment of obesity in children, adolescents, and adults. These articles also lay the foundation for the role that psychologists can and need to play in arresting and, ultimately, reversing, obesity in the United States and around the world. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

4.
Am Psychol ; 75(2): 189-203, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32052994

RESUMO

Although binge-eating disorder may manifest in childhood, a significantly larger proportion of youth report episodes involving a loss of control while eating, the hallmark feature of binge eating that predicts excess weight gain and obesity. Adults with binge-eating disorder often report that symptoms emerged during childhood or adolescence, suggesting that a developmental perspective of binge eating may be warranted. Thus, loss of control eating may be a marker of prodromal binge-eating disorder among certain susceptible youth. The present article offers a broad developmental framework of binge-eating disorder and proposes areas of future research to determine which youths with loss of control eating are at risk for persistent and exacerbated behavior that may develop into binge-eating disorder and adult obesity. To this end, this article provides an overview of loss of control eating in childhood and adolescence, including its characterization, etiology, and clinical significance, with a particular focus on associations with metabolic risk, weight gain, and obesity. A conceptual model is proposed to further elucidate the mechanisms that may play a role in determining which youths with loss of control are at greatest risk for binge-eating disorder and obesity. Ways in which treatments for adult binge-eating disorder may inform approaches to reduce loss of control eating and prevent excess weight gain in youth are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

5.
Am Psychol ; 75(2): 204-218, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32052995

RESUMO

This randomized controlled trial (RCT) tested effectiveness of adaptive SMART stepped-care treatment to "standard" behavioral weight loss (BWL [standard]) for patients with binge-eating disorder (BED) and obesity. One hundred ninety-one patients were randomly assigned to 6 months of BWL (standard; n = 39) or stepped care (n = 152). Within stepped care, patients started with BWL for 1 month; treatment responders continued BWL, whereas nonresponders switched to cognitive-behavioral therapy (CBT), and patients receiving stepped care were additionally randomized to weight-loss medication or placebo (double-blind) for the remaining 5 months. Independent assessments were performed reliably at baseline, throughout treatment, and posttreatment. Intent-to-treat (ITT) analyses of remission rates (zero binges/month) revealed that BWL (standard) and stepped care did not differ (74.4% vs. 66.5%); within stepped care, remission rates ranged 40.0% to 83.3%, with medication significantly superior to placebo (overall) and among nonresponders switched to CBT. Mixed-models analyses of binge-eating frequency revealed significant time effects, but BWL (standard) and stepped care did not differ; within stepped care, medication was significantly superior to placebo and among nonresponders switched to CBT. Mixed models revealed significant weight loss, but BWL (standard; 5.1% weight-loss) and stepped care (5.8% weight-loss) did not differ; within stepped care (range = 0.4% to 8.8% weight-loss), medication was significantly superior to placebo and among both responders continued on BWL and nonresponders switched to CBT. In summary, BWL (standard) and adaptive stepped-care treatments produced robust improvements in binge eating and weight loss in patients with BED/obesity. Within adaptive stepped care, weight-loss medication enhanced outcomes for BED/obesity. Implications for clinical practice and future adaptive designs are offered. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

6.
BMC Med ; 18(1): 21, 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-31983345

RESUMO

An update of the chapter on Mental, Behavioral and Neurodevelopmental Disorders in the International Classification of Diseases and Related Health Problems (ICD) is of great interest around the world. The recent approval of the 11th Revision of the ICD (ICD-11) by the World Health Organization (WHO) raises broad questions about the status of nosology of mental disorders as a whole as well as more focused questions regarding changes to the diagnostic guidelines for specific conditions and the implications of these changes for practice and research. This Forum brings together a broad range of experts to reflect on key changes and controversies in the ICD-11 classification of mental disorders. Taken together, there is consensus that the WHO's focus on global applicability and clinical utility in developing the diagnostic guidelines for this chapter will maximize the likelihood that it will be adopted by mental health professionals and administrators. This focus is also expected to enhance the application of the guidelines in non-specialist settings and their usefulness for scaling up evidence-based interventions. The new mental disorders classification in ICD-11 and its accompanying diagnostic guidelines therefore represent an important, albeit iterative, advance for the field.

7.
J Consult Clin Psychol ; 88(2): 172-178, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31894997

RESUMO

OBJECTIVE: To test the validity and clinical utility of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) severity specifiers for binge-eating disorder (BED) in predicting treatment outcomes. METHOD: Participants (N = 521) were patients in randomized controlled trials (RCTs) at 1 medical center testing treatments for BED; data were aggregated from RCTs testing cognitive-behavioral therapy (CBT), behavioral weight loss (BWL), and/or multimodal (i.e., CBT or BWL plus pharmacotherapy) treatment. Participants were categorized according to DSM-5 severity specifiers for BED: "mild" (n = 273; 52.5%), "moderate" (n = 182; 34.9%), and "severe/extreme" (n = 58; 11.1%). Participants had their weight and height measured and were assessed using established interviews and self-report measures at baseline, throughout treatment, and post treatment. RESULTS: Mixed models revealed that severity category did not significantly predict treatment response. However, there were main effects of BED severity category: "Severe/extreme" BED had greater binge-eating frequency and had greater global eating-disorder psychopathology than did "mild" BED across all time points. "Severe/extreme" BED was less likely to have remission from binge eating than was "mild" BED. Weight loss and depression scores did not significantly differ by severity category. CONCLUSION: In a large series of treatment-seeking individuals with BED aggregated across RCTs at 1 medical center testing psychological and pharmacological treatments for BED, DSM-5 severity specifiers for BED had limited validity and utility predicting response to treatments. Future research is needed to identify more robust severity indicators with clinical utility to inform future DSM revisions and clinical practice. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

8.
Int J Eat Disord ; 53(1): 85-95, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31769054

RESUMO

OBJECTIVES: This study compared the patterns of moderate and vigorous physical activity (PA) and health conditions in a nationally representative sample of adults categorized with healthy weight (HW) without eating disorder history, obesity without eating disorder history (OB), or current binge-eating disorder (BED) with obesity (BED+OB). METHOD: We used the third National Epidemiological Survey on Alcohol and Related Conditions to compare PA intensity, duration, and their relationships with health indicators in the three groups: HW (n = 11,635), OB (n = 11,056), and BED+OB (n = 110). RESULTS: Prevalence of physical inactivity was significantly greater in OB (38.1%) and BED (51.4%) than HW (30.3%). Prevalence of vigorous PA was significantly lower in OB (45.5%) and BED (31.7%) than HW (54.0%). Duration of moderate and vigorous activity per week was significantly shorter in BED+OB than HW and duration of vigorous activity was shorter in OB than HW. Regardless of PA intensity, BED+OB reported poorer physical and mental health than OB and HW. Greater PA intensity and duration were associated with better physical health, particularly in OB. DISCUSSION: In this nationally representative study of U.S. adults, obesity was associated with physical inactivity. Comorbid obesity and BED was associated with lower PA levels and poorer health. Particularly among adults with obesity, greater PA intensity was associated with better physical health, and greater duration of PA was associated with better physical and mental health. The findings highlight the importance of screening for BED in addition to obesity status and for promoting PA to improve health in U.S. adults.

9.
J Adolesc Health ; 66(2): 189-194, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31611138

RESUMO

PURPOSE: Pediatric obesity and eating disorders have adverse consequences on children's health and psychosocial functioning. Parents are involved in children's daily lives and their health, but the extent to which children's eating behaviors or weight impact parents' daily functioning is unknown. METHODS: The present study examined parent and child impairment because of child eating problems and weight in key life domains, including work/school, social life, and family life. Participants were parents (N = 861; 35.5% fathers) who completed an online cross-sectional survey, including perceived impairment because of their child's weight and eating behaviors. RESULTS: Overall, 7.0% of parents reported clinically significant impairment because of child weight, and 6.9% reported clinically significant impairment because of child eating behaviors. Significantly more parents of children categorized as having obesity reported clinically significant parent and child impairment than other weight categories. Parents of children who regularly engaged in secretive eating reported greater child impairment than those without problematic eating. When child weight and problematic eating behaviors were analyzed jointly with parent sex, child sex, and parents' overinvestment in their child's weight, parents' overinvestment in child weight was associated significantly with parent and child impairment, and secretive eating maintained a significant association, but weight status was no longer associated significantly with impairment. CONCLUSIONS: Understanding and considering individual and family impairment associated with obesity and problematic eating behaviors is critical for family-based prevention and treatment programs.

10.
Int J Eat Disord ; 53(1): 20-30, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31497876

RESUMO

OBJECTIVE: This study examined whether sex predicted and/or moderated treatment outcomes among men and women who participated in binge-eating disorder (BED) randomized controlled trials (RCTs). METHOD: Data were aggregated from RCTs performed at one medical center. RCTs tested cognitive-behavioral therapy, behavioral weight loss, multimodal treatment, and/or control conditions. Participants were 660 adults, both men (n = 170) and women (n = 490), with Diagnostic and Statistical Manual-fourth edition (DSM-IV)-defined BED. Doctoral-level research-clinicians assessed participants using structured interviews and established self-report measures of eating-disorder psychopathology and depression, and measured height and weight. Assessments occurred at baseline, throughout treatment, and at post-treatment. RESULTS: Sex was not a significant moderator of any treatment outcomes. Mixed models revealed sex had a main effect: men had lower eating-disorder psychopathology and lost more weight than women over the course of treatment. DISCUSSION: Both epidemiological and RCT studies report disparities in treatment-seeking between men and women with BED. Despite this, men have comparable or better treatment outcomes compared with women, including significantly greater weight loss. Thus, disseminating evidence-based BED treatments is promising for both men and women. Additional research is necessary, however, to understand treatment effects-including other predictors and moderators of outcomes-across diverse providers, treatment settings, and patient groups.

11.
Transl Behav Med ; 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31816053

RESUMO

Early weight loss is associated with greater weight loss following treatment cessation and years later. The present study aimed to identify pretreatment correlates associated with early weight loss in adults participating in weight-loss treatment in primary care. Participants (N = 89) were in the overweight/obesity range seeking weight-loss treatment in primary-care settings and randomized to one of three treatments: Motivational Interviewing and Internet Condition (MIC), Nutrition Psychoeducation and Internet Condition (NPC), or Usual Care (UC). At baseline, participants were assessed with the Eating Disorder Examination (EDE) interview and completed self-report measures of emotional overeating, exercise, exercise self-efficacy, and depression. Percent weight loss at week six was used as the Early Weight Loss variable. MIC/NPC groups had significantly greater Early Weight Loss than UC. Among MIC/NPC participants only, greater Early Weight Loss was associated with significantly lower pretreatment disordered eating and depressive symptoms. Participants in MIC/NPC who achieved clinically meaningful weight loss (>2.5%) by week six compared with those who did not (<2.5%) reported lower pretreatment disordered eating. Demographic factors and binge-eating disorder diagnosis were unrelated to Early Weight Loss. Our findings suggest that greater early weight loss may be associated with less pretreatment disordered eating and depressive symptoms. CLINICAL TRIALS: NCT01558297.

12.
Int J Eat Disord ; 2019 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-31670848

RESUMO

OBJECTIVE: The increased occurrence of disordered eating behaviors among sexual minorities is well established; however, few studies have examined disparities in eating disorder diagnoses among this population. This study sought to examine lifetime prevalence estimates of DSM-5 defined EDs, including anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED) as a function of sexual orientation. We then compared prevalence of EDs based on experiences with perceived discrimination. METHOD: A nationally representative sample of U.S. adults (N = 35,995) participating in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III completed structured diagnostic interviews. RESULTS: Prevalence rates were significantly higher among sexual minorities than heterosexual respondents for all EDs: AN = 1.71% (SE = 0.50) versus 0.77% (SE = 0.07), BN = 1.25% (SE = 0.37) versus 0.24% (SE = 0.03), BED = 2.17% (SE = 0.52) versus 0.81% (SE = 0.05). Odds of lifetime diagnosis were significantly greater among sexual minorities for AN (adjusted odds ratio [AOR] = 1.93), BN (AOR = 3.69), and BED (AOR = 2.32), after adjusting for sociodemographic variables. Sexual minorities reporting experiences with perceived discrimination had significantly higher prevalence of AN than those not endorsing perceived discrimination: 3.78% (SE = 1.43) versus 0.82% (SE = 0.33); AOR = 5.06. There were no significant differences in prevalence of BN or BED by perceived discrimination. DISCUSSION: Findings indicate that sexual minorities are disproportionately affected by EDs. Further research is needed to better understand mechanisms contributing to these disparities and heightened risk for EDs.

13.
Eat Disord ; : 1-8, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675284

RESUMO

This study examined self-weighing behaviors and correlates in patients with BED. Hypotheses: (1) women would weigh more frequently than men, (2) > weekly weighers would have higher restraint scores than < weekly weighers, (3) the self-weighing-restraint relationship would be stronger in women, (4) self-weighing frequency would be inversely related to BMI, and (5) self-weighing frequency and depression would be independently but not interactively related to BMI. The EDE, administered by trained doctoral-level interviewers, assessed self-weighing and eating-disorder psychopathology in 423 treatment-seeking individuals meeting DSM-5 BED criteria. Self-weighing frequency (1) did not differ by gender (Wald = 1.3; p = .3). (2) > weekly weighers reported significantly higher restraint (2.0±1.2 versus 1.6±1.3; t(421) = 3.1, p = .02). (3) No significant gender*self-weighing interaction on restraint (p = .99). (4) Self-weighing is inversely correlated with BMI (rho = -0.20; p < .001). 5) Self-weighing nor depression, nor self-weighing*depression interaction predicted BMI (p = .51). These analyses lay the groundwork for further investigation of the role of self-weighing in BED treatment.

14.
Obesity (Silver Spring) ; 27(12): 1982-1987, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31603628

RESUMO

OBJECTIVE: This study examined associations of different aspects of weight bias, which can include negative attitudes toward and beliefs about obesity, with eating/weight-related psychopathology. METHODS: Participants (N = 544) were White (n = 376) and Latino (n = 168) men living in the United States who completed an online battery of established measures of weight bias (both attitudes toward and beliefs about obesity) and eating/weight-related psychopathology. RESULTS: Among White men, negative attitudes toward obesity were associated significantly with dietary restraint, overvaluation of weight/shape, and body dissatisfaction, whereas among Latino men, negative attitudes toward obesity were associated significantly with overvaluation of weight/shape. Among White men, less negative attitudes toward people with obesity were associated with decreased use of compensatory behaviors, and weaker beliefs about the controllabilty of obesity were associated with decreased overeating and binge eating. Among Latino men, neither attitudes about people with obesity nor beliefs about the controllability of obesity were associated with eating-disordered behaviors. CONCLUSIONS: Weight bias was related to eating/weight-related psychopathology in men, with fewer associations observed among Latino men than White men. This highlights that associations with psychopathology may vary by ethnicity. Future research is needed to clarify the mechanism by which weight-biased attitudes and beliefs are associated with eating/weight-related psychopathology and why this might differ between White and Latino men.

15.
J Psychosom Res ; 126: 109757, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31522010

RESUMO

OBJECTIVE: We examined distinctiveness of different aspects of body-image disturbance in persons categorized with eating/weight disorders. We compared dissatisfaction with weight/shape, overvaluation of weight/shape, preoccupation with weight/shape, and fear of weight gain - in three study groups of persons categorized with overweight/obesity [O/O], bulimia nervosa [BN], and binge-eating disorder [BED] and examined how each body-image construct relates to clinical measures within and between the study groups. METHOD: 1017 community volunteers completed measures of body-image, eating-disorder psychopathology, and depression. Participants were categorized into three study groups: O/O (N = 511), BN-purging type (N = 167), and BED (N = 339). RESULTS: Groups differed significantly on the four body-image constructs (medium-to-large effect sizes) with a consistent severity gradient with BN greater than BED greater than O/O. Both within and between groups, the four body-image constructs varied in strengths of association among themselves and with clinical measures. Analyses revealed considerable variability in variance accounted for in the clinical measures; distinctive significant patterns observed across the groups included: dissatisfaction with BMI, preoccupation and fear with eating concerns and restraint, and overvaluation with depression. CONCLUSION: Clinical manifestations of body-image disturbances are complex and show important differences across study groups defined as overweight/obesity, BN, and BED. Improved understanding of distinctions between different body-image constructs and their differential salience across different eating/weight disorders is needed to improve case conceptualization and treatment formulation.

16.
Int J Eat Disord ; 52(11): 1229-1236, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31486125

RESUMO

OBJECTIVE: This study examined the distinctiveness of specific constructs of body-image disturbance in patients with anorexia nervosa (AN) and bulimia nervosa (BN). We compared weight/shape dissatisfaction, weight/shape overvaluation, weight/shape preoccupation, and fear of weight gain in patients with AN and BN and examined how each specific body-image construct relates to clinical measures within and between AN and BN. METHOD: A clinical sample of 490 treatment-seeking patients diagnosed with DSM-5 AN (N = 310) or BN (N = 180) by clinicians using structured interviews in Portugal completed the Eating Disorder Examination-Questionnaire to assess body image and eating-disorder (ED) psychopathology. RESULTS: Both within and between AN and BN, the four body-image constructs varied in their strengths of association among themselves, with ED psychopathology, and body mass index (BMI). Analyses revealed considerable variability in variance accounted for in clinical measures by body-image constructs. Body-image constructs predicted significant, albeit small, variance in BMI within BN (dissatisfaction, preoccupation significant) but not within AN. Body-image constructs predicted significant, albeit small, variance in the frequencies of binge eating and purging in AN (with preoccupation significant for both and fear for purging) but not within BN. Body-image constructs predicted significant variance in ED psychopathology (large amounts of variance for Eating Concern and Restraint) within both AN and BN (with overvaluation, preoccupation, and fear significant). CONCLUSION: Clinical manifestations of body-image disturbances are complex and show important differences across AN and BN. Understanding distinctions and differential salience of different body-image constructs across different EDs can inform refinement of specific case conceptualization.

17.
Surg Obes Relat Dis ; 15(10): 1829-1835, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31494065

RESUMO

BACKGROUND: Assessing the complexities of eating behaviors in patients who undergo bariatric surgery is challenging. The Eating Loss of Control Scale (ELOCS), a measure of loss-of-control (LOC) eating, has not yet been evaluated psychometrically among bariatric surgery patients. OBJECTIVE: This study presents a psychometric examination of the ELOCS in postoperative bariatric surgery patients. SETTING: Academic medical center in the United States. METHODS: One hundred seventy-one postbariatric treatment-seeking adults (82.5% female, 52.4% white) with LOC eating completed the ELOCS and measures assessing eating psychopathology and mood. Confirmatory factor analysis (CFA) was used to test fit for a 1-factor solution. Exploratory factor analysis (EFA) examined alternative factor structures. RESULTS: CFA revealed poor fit for a 1-factor structure (χ2 = 220.375, degrees of freedom = 135, P < .001, comparative fit index = .917, Tucker-Lewis index = .906, root mean square error of approximation = .067). EFA data suggested an alternative factor solution (χ2 = 157.76, degrees of freedom = 118, P = .009, comparative fit index = .965, Tucker-Lewis index = .955, root mean square error of approximation = .047). Factor 1 (α = .88) reflected behavioral aspects and factor 2 (α = .92) reflected cognitive/emotional aspects of LOC eating. Bivariate correlations with measures of eating and other psychopathology suggested good construct validity for factors. CONCLUSIONS: Findings suggest possible differences in the construct validity of the ELOCS among postbariatric patients. The 1-factor solution previously supported in clinical and nonclinical groups demonstrated poor fit. EFA revealed a possible alternative 2-factor solution that aligns with emerging literature, suggesting that LOC eating presents differently in postbariatric patients. Researchers interested in LOC eating among bariatric patients should consider use of the ELOCS and testing the proposed alternative factor structure.

18.
Int J Clin Pract ; 73(11): e13401, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31397950

RESUMO

OBJECTIVE: While physical activity (PA) is known to have positive effects on psychological and physical health, little is understood about the association between non-compensatory PA (ie, not compulsive or intended to control weight or shape) and psychopathology among individuals with eating-disorder features. The present study explored associations between non-compensatory PA and psychopathology among adults categorised with bulimia nervosa (BN) and binge-eating disorder (BED). We further explored the association between compensatory PA and psychopathology among those who engaged in that form of "purging." METHOD: Participants were recruited through Mechanical Turk, an online recruitment platform. Individuals categorised with core features of BED (N = 138) and BN (N = 138) completed measures of eating-disorder psychopathology (Eating Disorder Examination - Questionnaire [EDE-Q] and Questionnaire on Eating and Weight Patterns - 5), depression (Patient Health Questionnaire - 2) and PA (both non-compensatory and compensatory, measured using the EDE-Q and Godin Leisure-Time Exercise Questionnaire). RESULTS: Engagement in non-compensatory PA was associated with lower frequency of binge-eating episodes, lower overvaluation of shape/weight and lower dissatisfaction with shape/weight (Ps < .05). Engagement in compensatory PA was related to greater frequency of binge-eating episodes and greater restraint (Ps < .05). DISCUSSION: Non-compensatory PA was associated with lower eating-disorder psychopathology. This suggests that PA is an important, though understudied, health behaviour among persons with features of BED and BN. Future research should examine the potential role of non-compensatory PA in interventions for individuals with core features of these eating disorders.


Assuntos
Transtorno da Compulsão Alimentar/psicologia , Bulimia Nervosa/psicologia , Exercício/psicologia , Comportamento Alimentar/psicologia , Adulto , Transtorno da Compulsão Alimentar/fisiopatologia , Peso Corporal , Bulimia/diagnóstico , Bulimia Nervosa/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Masculino , Inquéritos e Questionários
19.
Mayo Clin Proc ; 94(8): 1415-1426, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31324401

RESUMO

OBJECTIVE: To investigate, in a nationally representative sample of US adults, the prevalence of help-seeking in individuals with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) eating disorders (EDs) and to examine sex and ethnic/racial differences. PATIENTS AND METHODS: The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N=36,309) included respondents who met the criteria for specific lifetime DSM-5 EDs and answered questions regarding help-seeking for their ED symptoms (anorexia nervosa [AN]: n=275; bulimia nervosa [BN]: n=91; and binge-eating disorder [BED]: n=256). RESULTS: The prevalence (standard error) estimates of ever seeking any help for AN, BN, and BED were 34.5% (2.80%), 62.6% (5.36%), and 49.0% (3.74%), respectively. Adjusting for sociodemographic characteristics, men and ethnic/racial minorities (non-Hispanic blacks and Hispanics) were statistically significantly less likely to ever seek help for BED than were women or non-Hispanic whites, respectively. Hispanics also were significantly less likely to seek help for AN relative to non-Hispanic whites. CONCLUSION: This was the first study in a nationally representative sample of US adults to examine rates of help-seeking, including by sex and ethnic/racial differences, across DSM-5-defined EDs. These findings emphasize the need to develop strategies to encourage help-seeking among individuals with EDs, particularly among men and ethnic/racial minorities.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Comportamento de Busca de Ajuda , Adulto , Idade de Início , Doença Crônica , Grupos de Populações Continentais/estatística & dados numéricos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Grupos Étnicos/estatística & dados numéricos , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Determinação de Necessidades de Cuidados de Saúde , Prevalência , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Inquéritos e Questionários , Estados Unidos , Adulto Jovem
20.
Obesity (Silver Spring) ; 27(8): 1367-1371, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31265763

RESUMO

OBJECTIVE: This study aimed to examine the prevalence of overvaluation of shape or weight in a nationally representative sample of U.S. adults with binge-eating disorder (BED) and to compare functioning correlates using a group of adults with bulimia nervosa (BN). METHODS: Participants included 207 respondents from the National Epidemiologic Survey on Alcohol and Related Conditions who met Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) diagnoses of BED (n = 163) or BN (n = 44). Sociodemographic characteristics and functioning were compared in BED with overvaluation (BED+OV), BED without overvaluation (BED), and BN. RESULTS: Approximately 50% of BED respondents reported overvaluation. Mean age was lower in BN than BED. Mean BMI was lower in BED+OV than BED and higher than BN. A greater proportion of BED+OV reported functional impairment than BED. BN was more likely to report "serious problems doing daily tasks" than BED and less likely to report "impairment in normal activities" than BED+OV. BN reported significantly lower mental functioning than BED. CONCLUSIONS: Findings based on this nationally representative sample are that overvaluation was associated with greater functional impairment within BED, and BED+OV reported greater impairment than BN in interference with normal activities but less impairment related to mental health. The increased impairment associated with BED+OV provides support for overvaluation as a diagnostic specifier for BED.

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