Oxytocin Effects on Food Stimulus Processing and FoodIntake in Females With or Without Binge Eating Disorder.

BackgroundBinge eating disorder (BED) represents a distinct eating disorder diagnosis. Current approaches assume increased impulsivity to be one factor leading to binge eating and weight gain. We used eye tracking to investigate both components of impulsivity, namely reward sensitivity and rash-spontaneous behaviour towards food in BED for the first time.MethodsOverweight and obese people with BED (BED+; n = 25), without BED (BED−; n = 26) and healthy normal-weight controls (NWC; n = 25) performed a free exploration paradigm measuring reward sensitivity (experiment 1) and a modified antisaccade paradigm measuring disinhibited, rash-spontaneous behaviour (experiment 2) using food and nonfood stimuli. Additionally, trait impulsivity was assessed.ResultsIn experiment 1, all participants located their initial fixations more often on food stimuli and BED+ participants gazed longer on food stimuli in comparison with BED− and NWC participants. In experiment 2, BED+ participants had more difficulties inhibiting saccades towards food and nonfood stimuli compared with both other groups in first saccades, and especially towards food stimuli in second saccades and concerning sequences of first and second saccades. BED− participants did not differ significantly from NWC participants in both experiments. Additionally, eye tracking performance was associated with self-reported reward responsiveness and self-control.ConclusionsAccording to these results, food-related reward sensitivity and rash-spontaneous behaviour, as the two components of impulsivity, are increased in BED in comparison with weight-matched and normal-weight controls. This indicates that BED represents a neurobehavioural phenotype of obesity that is characterised by increased impulsivity. Interventions for BED should target these special needs of affected patients.

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. 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. 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. 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.

ObjectiveThis review aimed to examine the validity of self‐report screening questionnaires for identifying eating disorder (ED) risk in adults and adolescents with overweight/obesity.MethodFive databases were searched from inception to September 2020 for studies assessing validation of self‐report ED screening questionnaires against diagnostic interviews in adolescents and adults with overweight/obesity. The review was registered with PROSPERO (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=220013).ResultsTwenty‐seven papers examining 15 questionnaires were included. Most studies validated questionnaires for adults (22 of 27 studies), and most questionnaires (12 of 15) screened for binge eating or binge‐eating disorder (BED). The Eating Disorder Examination Questionnaire (sensitivity = .16–.88, specificity = .62–1.0) and Questionnaire on Eating and Weight Patterns (sensitivity = .07–1.0, specificity = .0–1.0) were most frequently validated (six studies each). Five studies of three questionnaires were in adolescents, with the Adolescent Binge‐Eating Disorder Questionnaire having highest sensitivity (1.0) but lower specificity (.27). Questionnaires designed to screen for BED generally had higher diagnostic accuracy than those screening for EDs in general.DiscussionQuestionnaires have been well validated to identify BED in adults with overweight/obesity. Validated screening tools to identify other EDs in adults and any ED in adolescents with overweight/obesity are lacking. Thus, clinical assessment should inform the identification of patients with co‐morbid EDs and overweight/obesity.Public SignificanceIndividuals with overweight/obesity are at increased risk of EDs. This review highlights literature gaps regarding screening for ED risk in this vulnerable group. This work presents possibilities for improving care of individuals with overweight/obesity by reinventing ED screening tools to be better suited to diverse populations.

<p id=p00010>Eating behavior is not only regulated by the biological needs of people, but is also affected by emotional states, motivations, diseases, and more. There is a complex relationship between emotion and eating behavior. Consuming food can influence peoples emotion. On the other hand, food attention, subjective appetite, and food intake can be influenced by emotion. Many studies have focused on emotional eating due to negative emotions. However, fewer studies focus on the effect that positive emotion has on eating behavior. The relationship between positive emotion and eating behavior is still controversial, as the relationship is underrepresented in research. The present study analyzed the eating behavior of clinical and non-clinical individuals who were affected by negative or positive emotions, and further explored the neurophysiology of eating behaviors and the various theories of the effect that emotions have on eating behaviors. The results showed that negative emotion increased attentional bias and intake for food and subjective appetite in the general population. This process was also affected by other factors; for example, modest women may restrict their food intake while experiencing negative emotions, so they may regain a sense of control which would offset the unpleasant feelings they were experiencing. In this study, there were two results regarding the effect that positive emotion has on eating behaviors. One theory was that positive emotions broaden momentary thought-action repertoires of people, which in turn builds their endurance. This leads us to believe that people resist food intake after positive emotion is induced. However, contrarily, positive emotion could increase hedonistic behavior in people, thus increasing food intake to maintain the experience of pleasure. Negative emotion increased both attention bias for food cues and subsequent intake in people with bulimia nervosa and binge eating disorders. Negative emotion causes decreased food intake in people suffering from anorexia nervosa. Positive emotion decreased binge eating in people with bulimia nervosa and binge eating disorders and relieved restrictive eating behaviors in people with anorexia nervosa. According to the reward theory, negative emotion can enhance reward sensitivity toward food. Following increased food intake, this process may show a synergy effect in the amygdala, insula, orbitofrontal cortex, striatum, and ventromedial prefrontal cortex. Negative emotion ruins the inhibitory control of individuals, meaning that they may begin to overeat, in association with the activation of the anterior cingulate cortex. According to self-related theory, negative emotion induces negative self-awareness. People can show attention bias due to immediate environmental stimulus, as overeating is meant to help people escape from their own negative self-awareness. Placing their attention on binge eating allows people with bulimia or other binge eating disorders to avoid dealing with information or environmental stimulus that may be hurtful. From the perspective of social culture, most eating behaviors with positive emotion have some special or celebratory meaning which increases the hedonic-oriented eating behavior of the individual. In general, the association between emotion and eating behavior has a certain regularity to follow. In the study, during a negative emotion, an individual’s eating behavior manifested in an extreme, unhealthy pattern, whether that meant an increased or decreased food intake. This study found a direct association between emotion and eating behavior; However, social culture, symbolism and connotation of certain foods, and an individual’s default eating styles (disinhibited and restrained eating) should be considered alongside the influence that emotion has on eating behaviors. In addition, most past studies self-reported food intake and subjective appetite as recorded by the individuals as the measurement. Future studies should adopt neuro-physiological methods to explore the effect of emotion on eating behavior and study a small set of neurons in the hypothalamus which regulates appetite, for example.

IntroductionObesity is a major public health problem and some developed countries have declared it ‘the modern day epidemic’. One of the major eating disorders that leads to obesity is BED, which involves consuming large quantities of high carbohydrate food. Studying the factors that cause and contribute to BED can help tackle this major health hazard and alleviate a huge burden on the nationalized health service.ObjectivesTo determine the frequency of Binge Eating Disorder (BED) among obese adults, and to study its relationship to depression, anxiety, life stressors, personality and self esteem.MethodsThe sample was a randomised sample of clinically obese individuals, body mass index (BMI) of 30 and above. The sample was collected from two sites; Nutrition Clinic in Student’s Hospital, Cairo University and a Private Nutrition Centre. 250 cases were recruited over one year. All patients were subjected to a clinical interview derived from Kasr El Aini sheet , and measurement of Waist- Hip Ratio. Assessment of depression and anxiety was through Beck Depression Inventory , Hamilton Depression Rating Scale and Taylor Manifest Anxiety Scale(TMAS). Other tools used were the Eysenck’s Personality Inventory, Eating Disorder Inventory -2.ResultsBED among obese adults was 48%; 83 % of them had drive for thinness, 25% were bulimics, 45 % had ineffectiveness feeling. Also 83 % had body dissatisfaction, 8% were perfectionism seeking, 43 % showed interpersonal distrust and 25% presented maturity fears. Impulsivity was scored high in 25% , 66.6%had social insecurity and 77% had severe Extraversion. All were statistically significant. On the other hand there were no statistical significant difference between obese adults with BED and those without on TMAS. Half percent of participants with BED and 34.6 percent of participant without BED had moderate level of anxiety. In addition , there were no significant difference between obese participants with BED and those without BED according to BDI. However, 83.3% of obese cases with BED while 60 % for those without BED had manifest depression ranging from mild to severe depression.ConclusionsObese adults with BED have more drive for thinness, body dissatisfaction, feeling of ineffectiveness, perfectionism seeking, interpersonal distrust, maturity fears and social insecurity than non BED. Extraversion and Neuroticism are also more among BED. There were no significance different between both group in relation to Anxiety and Depression.Disclosure of InterestNone Declared

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

In the historical development of psychiatric nosology, as in the rest of medicine, more severe disorders tend to be recognized before disorders with milder symptom profiles. Thus, psychiatric classifications recognized schizophrenia and melancholia before schizotypal personality disorder and dysthymia. So, too, with the classification of eating disorders; anorexia nervosa, which may result in death, was recognized many years before bulimia nervosa. The most recent addition to the psychiatric classification of eating disorders is “binge eating disorder.” The diagnosis of binge eating disorder is given to the many obese individuals who are distressed by recurrent binge eating, yet do not regularly engage in the compensatory behavior (e.g., vomiting or use of laxatives) that is seen in individuals with bulimia nervosa. Although binge eating disorder is not an official DSM-IV diagnosis, a variety of studies support its validity (1–4). A description of the disorder and its diagnostic criteria appear in DSM-IV Appendix B, titled “Criteria Sets and Axes Provided for Further Study.” Binge eating disorder is common among study groups drawn from weight-control programs (15%–50%), which show women are approximately 1.5 times more likely to have the disorder than men. In nonpatient community samples, a prevalence rate of 1%–4% has been reported (1, 3). Typically, the disorder begins in late adolescence or in the early 20s, often after weight loss from severe dieting. Common associated features include marked fluctuations in weight over time and a history of depression, anxiety, low self-esteem, somatic concern, and interpersonal sensitivity. Along with the recognition of binge eating disorder and its clinical features, there has been increasing interest in developing effective treatments for the disorder. Several studies have examined the relative efficacy of psychotherapeutic and psychopharmacological approaches (5). This case conference illustrates some of the challenges and rewards involved in the treatment of a patient with binge eating disorder.

Few studies have assessed the association between attention-deficit hyperactivity disorder (ADHD) and eating disorders (ED) separately in men and women, especially in representative samples. Using data from the National Comorbidity Survey Replication, lifetime and past 12-month prevalence of Diagnostic and Statistical Manual of Mental Disorders IV, ADHD was compared in men and women with and without diagnoses of Diagnostic and Statistical Manual of Mental Disorders IV ED and any binge eating (BE) using logistic regression models adjusted for gender and age. In both sexes, those with lifetime and past 12-month BE and binge eating disorder had significantly higher prevalence of ADHD than those without BE and binge eating disorder, respectively. Women with lifetime and past 12-month bulimia nervosa and lifetime anorexia nervosa also had significantly higher prevalence of ADHD compared with women without these diagnoses. Given that ADHD invariably began earlier than the ED, ADHD may be an important risk factor for subsequent BE and related ED, and there may be opportunities for intervention among youth with ADHD. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

The purpose of this chapter is to review the literature on the relationship between attention-deficit-hyperactivity-disorder (ADHD) and binge eating as seen in bulimia nervosa (BN) and binge eating disorder (BED), including the shared phenomenology, genetics and treatment. The authors reviewed all the published peer reviewed literature in the past decade available through PubMed on the epidemiology, phenomenology, genetics and management of binge eating behavior, especially as it manifests in eating disorders (BN, BED), as well as in obesity and within the context of ADHD throughout the lifespan. It was found that there is a significant association between ADHD and binge eating in clinical populations. Inattentiveness and impulsivity noted in ADHD are thought to play a role in the preoccupations, urges and impulsive behaviors of those who experience binge-eating episodes. Molecular genetic studies have also identified common genes involved in dopamine transport, suggesting a shared genetic predisposition to binge eating, obesity and ADHD. Case reports on individuals with BN and ADHD suggest benefit from psychostimulant medication. In addition, other anti-ADHD medications such as atomoxetine have been used independently in trials to treat obesity and BED. Individuals with current symptoms or a past history of ADHD are at risk of having coexisting binge eating and obesity. Screening for ADHD in patients with binge-eating behaviors may identify individuals who could benefit from anti-ADHD medications. Further research may help to identify shared neurobiological mechanisms and particular risk factors, as well as to determine the efficacy and tolerability of certain medications in this population.

Reproduction has been shown to be costly in viviparous skinks, both in terms of survival and in terms of growth and future reproductive output. One possible source of such costs could be a reduction in food intake, with an associated reduction in energy available for maintenance and future reproduction. Therefore, I compared food intake in male and female southern water skinks (Eulamprus tympanum), to determine whether food intake was reduced during reproduction in either sex. In addition, I measured the relationship between reduction in food intake and the total volume of offspring or testis. A reduction in food intake proportional to the volume of offspring suggests that costs associated with reduced energy intake may be fecundity dependent. Food intake was estimated using the total volume of stomach contents of individuals. Females ate significantly less (mean volume of stomach contents = 0.13mL) than males (mean = 0.36mL) just before parturition in January, when embryos were largest. After parturition, females ate significantly more than males. Otherwise, there were no significant differences between the food intake of males and females. Females reduced food intake by eating smaller food items. Females with relatively large numbers of ova or embryos ate relatively less, and therefore decreased food intake in females may be a fecundity‐dependent cost of reproduction in these lizards. Males did not reduce food intake during periods when testes were enlarged and mating occurred. Decreased food intake during reproduction is probably an important source of reproductive costs to females of these viviparous lizards, but does not appear to be important in males.

Back to table of contents Previous article Next article This article has been corrected | View Correction Letters to the EditorFull AccessBinge Eating Associated With Internal Carotid Artery AneurysmLINEN LIN M.D.SUSAN SHUR-FEN GAU M.D., Ph.D.MING-BEEN LEE M.D.,LINEN LIN M.D.Search for more papers by this authorSUSAN SHUR-FEN GAU M.D., Ph.D.Search for more papers by this authorMING-BEEN LEE M.D.Search for more papers by this author,Published Online:1 Aug 2006https://doi.org/10.1176/ajp.2006.163.8.1452AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: Prevalence rates of DSM-IV binge eating disorder and intracranial aneurysm have been estimated at 1% (1) and 2%–5% (2) . To our knowledge, there has been no report of comorbidity of these two conditions. We describe a case of a patient with internal carotid artery aneurysm presenting with symptoms similar to binge eating disorder. “Mrs. A,” a 32-year-old married woman with two children, presented at a psychiatric clinic in Jan. 2003 with depressive symptoms and uncontrollable binge eating episodes that had been recurrent for 2 months. She became fixated with her body weight and waist circumference. Psychosexual stressors from her husband’s extramarital affairs were also identified. Neither compensatory behavior nor a history of anorexia was elicited.Despite alleviation of her depressed mood and preoccupation with body weight following treatment with paroxetine (30 mg/day) and weekly psychotherapy for 4 months, her binge eating episodes persisted. She was then lost to follow-up for several months. Subsequently, she relapsed and presented with the following at her visit in Jan. 2004: binge eating episodes, overconcern with waist circumference, depressed mood, decreased self-esteem, psychomotor agitation, episodic headaches, blurred visions, increased body weight (from 47 kg to 54 kg in 4 months), and increased severity of stress from marital conflict. There was no identified temporal relationship between her headaches and hyperphagia episodes. Similar to prior pharmacotherapy, fluoxetine doses (40 mg/day) were effective in reducing her symptoms of depression and body image distortion rather than controlling her binge eating impulse. Her physical examination revealed no negative findings except galactorrhea. Neither papilledema nor other focal neurological sign was identified at neurological examination. Her serum level of prolactin was within normal range (8.27 ng/ml). A magnetic resonance image of her pituitary disclosed an engorged vessel from the right internal carotid artery A1 segment compressed on the right optic chiasma and hypothalamus ( Figure 1 ). An angiography showed a wide-based aneurysm (maximum width: 5 mm; height: 4 mm) at the supraclinoid segment of the right internal carotid artery. Her blurred vision and headaches subsided after microsurgical decompression. She did not suffer from any binge eating episode or body image distortion during the postoperation follow-up for 20 months. Figure 1. Coronal View of T2-Weighted (TR: 400 msec, TE: 120 msec) Image of Brain MRI Revealing Engorged Vessel Rising From the Right Internal Carotid Artery A1 Segment With Compression on the Right Optic Chiasma and Hypothalamus An association between bulimia and central nervous system lesions and increased intracranial pressure has been reported previously (3) . To our knowledge, Mrs. A is the first reported case of internal carotid artery aneurysm presenting with a binge eating disorder. The disproportional treatment responses and evidence for focal neurological signs suggest the necessity for organic workup. It is advisable to perform detailed physical assessment, endocrinological evaluation, and possible neuroimaging studies in patients with binge eating disorder who have unexpected responses to traditional treatment strategies. Furthermore, our case report may provide additional evidence of a neurological basis of binge eating disorder. One limitation to this report is that it lacks analysis of the potential neural substrates for binge eating disorder. Taipei, Taiwan

Food-related reward sensitivity across the spectrum of body weight and impulsive eating: Pilot findings from a multi-method approach

Effects of intranasal oxytocin in food intake and craving: A meta-analysis of clinical trials

Macronutrient effects on satiety and binge eating in bulimia nervosa and binge eating disorder

Although the cross-cultural prevalence of anorexia and bulimia nervosa has been investigated in multiple studies, little is known about the prevalence and correlates of binge eating and binge eating disorder (BED) cross-culturally. No published studies to date have explored BED in small-scale, indigenous, or developing societies. The current study investigated the prevalence and correlates of binge eating in a community sample of Fijian women living in rural Fiji. Fifty ethnic Fijian women completed a self-report measure developed for this study on dieting and attitudes toward body shape and change, a Nadroga-language questionnaire on body image, and the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R). Their height and weight were also measured. Patterns of dieting, high body mass index (BMI), and attitudes toward eating and body image were compared between women with and without a history of binge eating. Ten percent of respondents reported at least weekly episodes of binge eating during the past 6 months and 4% endorsed symptoms consistent with BED. Binge eating in this sample was associated significantly with a BMI value above 35, a history of dieting, and a high concern with body shape. Binge eating was not associated with several markers of acculturation in this sample, although it was associated with a key, nontraditionally Fijian (i.e., acculturated) attitude toward the body. Binge eating occurred in a social context with traditions concerning weight and diet widely disparate from Western populations. However, correlates of binge eating in this sample suggest that nontraditional Fijian attitudes toward weight and body shape play a contributory role.