Binge Behavior Research Articles

Binge-eating behaviors in adolescents and young adults during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic and subsequent public health measures have resulted in a worsening of eating disorder symptoms and an increase in psychological distress. The present study examined symptoms and behaviors in adolescents and young adults with emotional eating, bingeing behaviors and binge eating disorder during the pandemic. Additionally, the study explored if individuals who experienced pandemic-related food availability and food affordability issues experienced increased binge-eating symptoms and negative feelings.MethodParticipants (n = 39) were a convenience sample who participated between November 2020 and January 2021 in a weight and lifestyle management program at an urban New England pediatric hospital. Participants completed online surveys that assessed (1) participant’s exposure to COVID-19 related stress and binge-eating behaviors using the COVID-19 Exposure and Family Impact Survey-Adolescent and Young Adult Version (CEFIS-AYA) and the Binge Eating Scale (BES) respectively, (2) participants’ and their families’ ability to attain and afford food and its association with bingeing behaviors, and (3) the relationship between food availability and affordability and negative emotions.ResultsNearly half of all participants (48.7%) reported moderate to severe bingeing during the COVID-19 pandemic; those who experienced greater COVID-related stress reported more binge-eating behaviors (p = 0.03). There were no associations between indicators of food availability and affordability and binge eating or between food availability and affordability and negative feelings.ConclusionsHigher pandemic-related stress was associated with more binge-eating behaviors among adolescents and young adults. These results underscore the need to monitor symptoms and provide treatment for these patients despite barriers to care imposed by the COVID-19 pandemic. Research and clinical care for adolescents and young adults with EDs must recognize and respond to pandemic effects across the weight and disordered eating spectrum.

Relationship of depression, impulsivity, distress intolerance and coping styles with maladaptive eating patterns in bariatric candidates.

The study aimed to investigate the problematic eating patterns and understand their relationship to psychological constructs, including stress intolerance, coping mechanisms and impulsivity, and psychiatric symptoms among bariatric surgery candidates. The bariatric candidates were evaluated by psychiatric interview and standard scales assessing maladaptive eating behaviors (Eating Attitudes Test (EAT), Bulimia Investigatory Test-Edinburgh (BITE), Dutch Eating Behavior Questionnaire (DEBQ)), depression (Beck Depression Inventory (BDI)), psychiatric symptoms (Brief Symptom Inventory (BSI)), and psychological constructs (Distress Intolerance Index (DSI), Coping Styles Scale (CSS), UPPS Impulsive Behavior Scale(UPPS)). More than half (57.8%) had maladaptive eating behaviors, and 23.6% had binge-eating behavior. Depression and anxiety predicted EAT, BITE, and DEBQ emotional and external eating sub-scale scores; distress intolerance, helpless coping style, and impulsivity predicted maladaptive eating behaviors in bariatric candidates. Maladaptive eating patterns play an essential role in the failure to lose weight and regain weight and are predicted by depression, anxiety, and psychological constructs in this study. Evaluation of pathological trait characteristics besides discrete psychiatric syndromes should be recommended in the pre-operation process to plan relevant interventions in the long-term management of weight. Level III, evidence obtained from well-designed cohort analytic studies.

Interrater reliability and internal consistency of the eating disorder examination in the longitudinal assessment of bariatric surgery study.

Psychometric studies of eating disorder measures within bariatric surgery populations are limited. To examine the interrater reliability and internal consistency of the Eating Disorder Examination (EDE) among patients before and after bariatric surgery. Three clinical centers of the Longitudinal Assessment of Bariatric Surgery Research Consortium. The EDE-Bariatric Surgery Version was administered and audio-recorded by trained interviewers before and at annual assessments after bariatric surgery. Approximately 20% of interviews were randomly selected for rating by a second interviewer. Reliability of the original and brief EDE subscales was examined. Interrater reliability of the EDE subscales ranged from .86-.97 for the original subscales and .83-.95 for brief subscales before surgery, and .90-.98 for the original subscales and .92-.97 for brief subscales after bariatric surgery. Interrater agreement (based on kappa) was almost perfect for overeating and binge-eating behaviors and substantial for loss-of-control eating before surgery. Similar interrater agreements (based on kappa) were observed after surgery for subjective overeating and binge-eating episodes. Internal consistency of the subscale and global scores was variable, ranging from .41-.97. Findings provide support of the interrater reliability of the EDE, albeit with variable internal consistency, before and after bariatric surgery. Despite support for trained raters to reliably assess EDE constructs, variability in internal consistency suggests that further psychometric testing and rigorous scale development of disordered eating may be needed for the bariatric surgery population.

Gender Differences in the Psychopathology of Obesity: How Relevant Is the Role of Binge Eating Behaviors?

Background: Obesity is a condition that affects humans both physically and mentally. Moreover, many psychopathological conditions can be observed in obese patients that may threaten the positive outcomes of bariatric surgery. Purpose: The aim of this study was to identify the main psychopathological correlates of obese candidates for bariatric surgery, with particular attention on the relationship between psychopathology and gender. Methods: In total, 273 candidates for bariatric surgery for obesity underwent a psychiatric evaluation using a compilation of psychometric scales: the Revised Symptom Checklist 90-R (SCL-90-R), the Eating Disorder Examination Questionnaire (EDE-Q), the Binge Eating Scale (BES), the Body Uneasiness Test (BUT) and the Obesity-Related Well-Being (ORWELL 97). The sample was divided on the basis of gender and binge eating disorder (BED) severity. Comparisons between the groups were performed using an analysis of variance model (ANOVA) or a Pearson’s chi-squared test. Further, we also divided our sample into a severe binge eating group (score > 27), a mild to moderate group (18 < score < 26) and a low/no symptoms group (score < 17). Results: Male and female subjects showed different results for the BES, with higher scores reported among women (17.50 ± 9.59) compared to men (14.08 ± 8.64). Women also showed higher scores across most of the SCL-90-R domains and worse outcomes in terms of quality of life. Both women and men in the severe binge eating group reported higher scores for the SCL-90-R. Conclusion: The symptoms of BED, along with body image dissatisfaction (BID), are among the most important to investigate for candidates for bariatric surgery in order to improve the surgery outcomes. Level of evidence: Level III as the evidence came from a cohort analytic study.

Identifying eating disorders in adolescents and adults with overweight or obesity: A systematic review of screening questionnaires.

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.

Severe Hyperprolactinemia Promotes Brown Adipose Tissue Whitening and Aggravates High Fat Diet Induced Metabolic Imbalance.

BackgroundThe association of high serum prolactin and increased body weight is positive but controversial, therefore we hypothesized that additional factors such as diets and the impact of prolactin on brown adipose tissue may condition its metabolic effects.MethodsWe used LacDrd2KO females with lifelong severe hyperprolactinemia due dopamine-D2 receptor deletion from lactotropes, and slow onset of metabolic disturbances, and compared them to their respective controls (Drd2 loxP/loxP ). Food intake, and binge eating was evaluated. We then challenged mice with a High Fat (HFD) or a Control Diet (CD) for 8 weeks, beginning at 3 months of age, when no differences in body weight are found between genotypes. At the end of the protocol brown and white adipose tissues were weighed, and thermogenic and lipogenic markers studied, using real time PCR (Ucp1, Cidea, Pgc1a, Lpl, adiponectin, Prlr) or immunohistochemistry (UCP1). Histochemical analysis of brown adipose tissue, and glucose tolerance tests were performed.ResultsHyperprolactinemic mice had increased food intake and binge eating behavior. Metabolic effects induced by a HFD were exacerbated in lacDrd2KO mice. Hyperprolactinemia aggravated HFD-induced body weight gain and glucose intolerance. In brown adipose tissue pronounced cellular whitening as well as decreased expression of the thermogenic markers Ucp1 and Pgc1a were observed in response to high prolactin levels, regardless of the diet, and furthermore, hyperprolactinemia potentiated the decrease in Cidea mRNA expression induced by HFD. In subcutaneous white adipose tissue hyperprolactinemia synergistically increased tissue weight, while decreasing Prlr, Adiponectin and Lpl mRNA levels regardless of the diet.ConclusionsPathological hyperprolactinemia has a strong impact in brown adipose tissue, lowering thermogenic markers and evoking tissue whitening. Furthermore, it modifies lipogenic markers in subcutaneous white adipose, and aggravates HFD-induced glucose intolerance and Cidea decrease. Therefore, severe high prolactin levels may target BAT function, and furthermore represent an adjuvant player in the development of obesity induced by high fat diets.

The contribution of social media addiction to adolescent LIFE: Social appearance anxiety.

The use of social media by adolescents, who spend about 3 hours a day on social media, is dominated by visual communication. Nowadays, appearance ideals are presented through social media platforms. Exposure to these popular ideals of appearance could cause appearance-based anxiety and adolescents to develop binge-eating behavior. This cross-sectional study was conducted to determine social appearance anxiety, social media addictions, and emotional eating behaviors of adolescents. 1363 adolescents, living in the Central Anatolian Region of Turkey, were included in the study. Data were collected with a Questionnaire form, the Social Appearance Anxiety Scale (SAAS), Social Media Addiction Scale (SMAS), and Emotional Eating Scale (EES-C). 24.4% of adolescents are social media addicts. No relationship was found between adolescents’ social appearance anxiety, social media addictions, and emotional eating behaviors. However, social appearance anxiety and social media addictions of girls, those who perceive their family income as low and who think that they are influenced by social media influencers have higher anxiety. The value of this study is that it shows that gender, low income perception, time spent on social media, being influenced by influencers, following influencers who share diet and nutrition content, and social media addiction are associated with social appearance anxiety. As a result, it is thought that social media addiction and being affected by social media influencers increase social appearance anxiety in adolescents and pose a risk in terms of adolescents’ mental health.

Psychofarmacological approach for Binge- eating disorders

IntroductionBinge-eating disorder (BED), is one of the most common eating disorder. Treatment aims to reduce binge-eating frequency and disordered eating–related cognitions, improve metabolic health and weight, and regulate mood (in patients with coexisting depression or anxiety)ObjectivesThe aim of this study was to examine the efficacy of lisdexamfetamine dimesylate in a simple of 50 women with a binge eating disorder diagnosis compare with selective serotonin reuptake inhibitorMethodsTwo groups were made, one with lisdexamfetamine and the other with selective serotonin reuptake inhibitor (fluoxetine). 20 women were in each group (total n=40). The doses depend of the binge symptoms and rates were from 30 to 70md/day for lisdexamfetamine and for fluoxetine the doses were from 20 to 60mg/day.ResultsBinge behaviors decreased with a 50mg/day dose of lisdexamfetamine. The 70mg/day doses present also less binge behaviors but also more adverse events. The 30mg/day doses did not decrease binge-eating behaviors.ConclusionsLisdexamfetamine is the first pharmacological agent to receive FDA approval for use in adults with moderate to severe binge eating disorder. This study supports further assessment of lisdexamfetamine as a treatment option for decreasing binge eating behavior and also symptoms associated such as anxiety and obsessive and compulsive features in adults.Increased efficacy with increasing dosages of lisdexamfetamine suggests a dose-response relationship until 50mg/day. Women with a dose of 50mg/day of lisdexamfetamine report less adverse event, more adherence to treatment and improve their eating behaviors.DisclosureNo significant relationships.

“Feeling fat,” disgust, guilt, and shame: Preliminary evaluation of a mediation model of binge-eating in adults with higher-weight bodies

“Feeling fat” is a subjective state that theoretically contributes to the maintenance of binge eating (BE). However, feeling fat, and its relation to BE among individuals with higher-weight bodies, has been infrequently studied. This study proposes a momentary-level model in which negative moral emotion states (disgust, guilt, shame) mediate the association between feeling fat and binge eating. In this study, 50 adults with higher-weight bodies (MBMI=40.3 ± 8.5 kg/m2; 84% female) completed a two-week ecological momentary assessment protocol, which measured experiences of feeling fat, emotion states, and binge-eating behavior. Univariate generalized linear mixed models (GLMM) evaluated the momentary associations among levels of feeling fat at Time 1, emotion states at Time 2, and binge eating at Time 2, controlling for Time 1 emotion states. GLMM results suggest that increases in each emotion from Time 1 to Time 2 mediated the association between Time 1 feeling fat and Time 2 binge eating. When modeled simultaneously within one multivariate multilevel structured equation model, disgust appeared to drive the relation between feeling fat and binge eating, over and above guilt and shame. Although preliminary, findings suggest increases in negative moral emotions, particularly disgust, mediate the feeling fat-binge eating association in adults with higher-weight bodies.

Which dimensions of emotion dysregulation predict the onset and persistence of eating disorder behaviours? A prospective study

BackgroundTheoretical models highlight the importance of emotion dysregulation as a key risk and maintaining factor for eating disorders. However, most studies testing these theories are cross-sectional. It remains unclear which dimensions of emotion dysregulation account for the onset and persistence of eating disorder behaviours over time. MethodsTo address these gaps, data were analyzed from 1321 adult women who completed study measures at baseline and eight-month follow-up. The dimensions of emotion dysregulation assessed were five subscales from the abbreviated 16-item Difficulties in Emotion Regulation Scale. Outcomes included the onset (versus asymptomatic) and persistence (versus remission) of binge eating and compensatory behaviours. ResultsUnivariate logistic regressions showed that, among initially asymptomatic women, higher baseline levels of each emotion dysregulation dimension (except the “goals” subscale) predicted the onset of binge eating and compensatory behaviours at follow-up. Each dimension also predicted the persistence of compensatory behaviours at follow-up among women endorsing these behaviours at baseline, while the “impulse”, “strategies”, and “non-acceptance” dimensions predicted the persistence of binge eating. In multivariate analyses, only the “strategies” dimension predicted the onset and persistence of binge eating, while the “non-acceptance” dimension predicted the onset and persistence of compensatory behaviours. LimitationsOnly a limited number of emotion dysregulation dimensions were tested. ConclusionFindings demonstrate the importance of emotion dysregulation dimensions in accounting for the onset and maintenance of eating disorder behaviours. The delivery of specific intervention strategies designed to address emotion dysregulation may depend on the risk and symptom profile of an individual.

Eating Disorders: An Analysis of Self-Induced Vomiting, Binge Eating, and Oral Hygiene Behavior.

Background Self-induced vomiting (SIV) is often present in patients with eating disorders (ED) and potentially damaging for oral health. Related behaviors, such as binge eating and oral hygiene habits, may equally increase the risk for dental damage. This study aimed to investigate behaviors and habits in patients with ED and SIV in relation to oral health. Methods All patients enlisting for treatment in an ED clinic for 1 year were offered to take part in the study. Fifty-four of 65 patients were accepted to participate, and a questionnaire included questions on dietary and oral hygiene habits was included. A subgroup consisting of only those 17 ED patients who reported SIV during the previous six months comprised the sample for this study and received additional questions related to other compensatory behaviors and oral hygiene habits in relation to oral health. Results Binge eating before SIV was common (14/17 patients). Time point for SIV after binge eating and the procedures performed after vomiting varied. Tooth brushing after vomiting was common (7/17). Food and drinks during binge eating included mainly items rich in calories (sugar/fat) or acid. All 17 patients believed that vomiting could damage their teeth, but only one of them had informed the dentist about having an ED. A number of oral symptoms were reported. Ten patients considered their oral health to be good/fairly good, while the remaining seven patients reported their oral health as not so good/bad/very bad. Information on how ED could affect their teeth was commonly received from the media. Conclusions The dental team should be made aware of the likely detrimental effects of binge eating and vomiting on oral health in patients with eating disorders. The team should also be aware of the cyclical nature of the disease and the similarities and diversities that exist within this group of ED patients. Since ED patients hide their disease from the dental team, this stresses the importance of open and trustful communication between patients and health workers. An organized collaboration between ED clinics and dental professionals is suggested as well as a development of avenues for information about ED and oral health.

The impact of binge-like palatable food intake on the endogenous glucagon-like peptide-1 system in female rats

Binge eating involves consumption of large amounts of food and a loss of control over the amount consumed. The incidence of binge eating disorder is higher in females than males, hinting at important sex differences in binge eating behavior, but the neural underpinnings of binge eating still remain unresolved. Recent work in male rats has shown that a history of binge-like palatable food intake suppresses hindbrain expression of preproglucagon (PPG), the precursor for glucagon-like peptide-1 (GLP-1). Given the roles of GLP-1 in reducing feeding and food reward, this could be a mechanism underlying binge-like eating in rodents. However, whether similar effects occur in female rats is unknown. Here, we tested the hypothesis that a history of binge-like palatable food intake in female rats would reduce PPG expression in the nucleus tractus solitarius (NTS), a key central site of GLP-1 production. Female rats given access to vegetable shortening every fourth day (4D) engaged in binge-like feeding, demonstrated by consuming significantly more shortening during the first hour of fat access compared to counterparts with ad libitum (AL) fat access. After several weeks of fat access under these schedules, PPG and GLP-1 receptor (GLP-1R) expression were measured in the NTS and ileum. Surprisingly, and in contrast to previous findings in male rats, there were no significant differences in expression of PPG or GLP-1R in either site in 4D versus AL rats, nor were there effects on plasma GLP-1 levels. These findings highlight key differences in the effects of binge-like intake on the central GLP-1 system in female compared to male rats.

Frequency of binge eating behavior in patients with borderline personality disorder and its relation to emotional regulation and impulsivity.

Eating disorders are common among patients with borderline personality disorder (BPD), contributing to their lack of treatment response and bad prognosis. In this context, it is helpful to examine the relevance of eating behavior and to understand whether borderline traits are higher in those individuals. In this study, a sample of patients with BPD screened to determine the frequency of binge eating (BE) behaviors and its relation to impulsivity and emotional dysregulation. Seventy participants aged 25.81 ± 6.34years were recruited from Okasha Institute of psychiatry, Cairo, Egypt. Diagnosed by the Structured Clinical Interview for DSM-IV Axis II disorders (SCID-II), assessed for impulsivity, emotion regulation using the Barratt Impulsiveness Scale and the Trait Meta Mood Scale (TMMS), respectively, and screened for BE behaviors by Binge Eating Scale. All of the participants had medium emotional regulation propensity 82.63 ± 10.81 and showed variable degrees of impulsivity, mainly moderate 42 (60%). More than half of the participants had BE behavior 37 (~ 53%), with a significant negative correlation with clarity of feeling, total score of TMMS, and age. Similarly, on comparing the participant with binging versus no binging group, a significant relation between BE behavior, fear of abandonment (p value 0.02), clarity of feeling, and total score of TMMS was found. However, no significant relation between BE behavior & impulsivity demonstrated. A substantial number of patients with BPD suffering from BE, showing relation between binging, emotion dysregulation, and fear of abandonment. III, evidence obtained from well-designed cohort or case-control analytic studies.

Abstract MP69: Adolescent Experiences Of Racism: Associations With Cardiovascular Disease Risk-related Behaviors In A Diverse Population-based Sample

Introduction: Racism is increasingly accepted as a driver of health inequities, but little is known about how racism impacts cardiovascular health in young people. This paper tests the hypothesis that direct experiences of interpersonal racism in adolescence are associated with traditional and emerging cardiovascular disease risk-related behaviors using cross-sectional observational data. Methods: In Project EAT 2010, 1,396 young people (mean age = 14.4 years) reported how often they were teased or harassed about their race, a form of direct interpersonal racism. Participants also reported cardiovascular disease risk-related behaviors: traditional [smoking; not meeting moderate to vigorous physical activity (MVPA) recommendations] and emerging [unhealthy weight control behaviors; binge eating]. Multivariable logistic models assessed associations of direct interpersonal racism with cardiovascular disease risk-related behaviors, controlling for known confounders. Results: About 20% (268 of 1396) of young people reported experiencing interpersonal racism directly at least a few times a year. About one in ten participants reported binge eating or smoking in the past year and about half reported engaging in at least one unhealthy weight control behavior in the past year or not meeting MVPA recommendations. In adolescence, sometimes or frequently experiencing interpersonal racism directly was associated with greater odds of reporting smoking, binge eating and unhealthy weight control behaviors (see Table 1), relative to never or rarely experiencing interpersonal racism directly. There did not appear to be a further increase between “sometimes” to “frequently” experiencing interpersonal racism directly and odds of engaging in cardiovascular disease risk-related behaviors. Conclusions: These findings support a link between experiences of racism in adolescence and cardiovascular disease risk and further emphasize the need for structural interventions to achieve cardiovascular health equity.

Applying a web-based self-help intervention for bulimia nervosa in routine care: Study protocol for a randomized controlled trial

BackgroundIndividuals with bulimia nervosa (BN) experience persistent episodes of binge eating and inappropriate compensatory behavior associated with impaired physical and mental health. Despite the existence of effective treatments, many individuals with BN remain untreated, leading to a high burden and an increased risk of chronicity. Web-based interventions may help facilitate access to evidence-based treatments for BN by reducing barriers to the health care system. MethodsThe present study will investigate the effectiveness of a web-based self-help intervention for BN in a two-armed randomized controlled trial. Individuals diagnosed with BN (N = 152) will be randomly assigned to either (1) an intervention group receiving a 12-week web-based intervention or (2) a waitlist control group with delayed access to the intervention. Further assessments will be scheduled 6 (mid-treatment) and 12 (post-treatment) weeks after baseline. Changes in the number of binge eating episodes and compensatory behaviors will be examined as primary outcomes. Secondary outcomes include global eating pathology, functional impairments, well-being, comorbid psychopathology, self-esteem, and emotion regulation abilities. DiscussionAdding web-based interventions into routine care is a promising approach to overcome the existing treatment gap for patients with BN. Therefore, the current study will test the effectiveness of a web-based intervention for BN under standard clinical care settings. Trial registrationClinicalTrials.gov, Identifier: NCT04876196 (registered on May 6th, 2021).

Examining the Clinical Correlates of Overeating and Binge-Eating Behaviors Among U. S. Veterans

Pressure to meet U.S. military weight requirements during service may predispose some service members to develop psychiatric disorders such as eating disorders or unhealthy eating behaviors, which may persist after military discharge. Specifically, research examining U.S. military veterans has found that in weight management programs, veterans with binge-eating behaviors have shown poor treatment outcomes. Overall, previous research suggests that veterans experience considerable and persistent disordered eating problems, and in addition may experience a higher prevalence of disordered eating in comparison to the general U.S. population. Research on Post-9/11 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans is needed as this group frequently presents with high rates of medical and psychiatric disorders. The current study used clinician-administered structured interviews to examine relationships between psychiatric, health, and demographic variables in a sample of Post-9/11 OEF/OIF/OND veterans with binge-eating or overeating behavior or neither. This article presents secondary analyses of the baseline phase from data obtained for the Survey of the Experiences of Returning Veterans. Using structured phone interviews, we cross-sectionally examined patterns of medical comorbidities between sociodemographic, health, eating, and psychiatric variables in 846 recently deployed U.S. veterans with binge-eating behaviors (reporting both overeating and loss of control [LOC] eating), overeating behaviors (overeating without LOC), or healthy controls (absence of any disordered eating). Study procedures were approved by the Department of Veterans Affairs (VA) Institutional Review Boards, and informed consent was obtained from the participants. A series of chi-square and analysis of variance tests revealed significant bivariate between-group differences in sociodemographic, health, eating, and psychiatric variables. Variables with significant group differences (P < .05) were entered into a multinomial logistic regression to examine relationships between psychiatric, health, and eating factors and binge-eating severity. Results of the multinomial logistic regression analysis showed that women relative to men were less likely to overeat. When comparing the binge-eating group and controls, higher body mass index was associated with higher odds of binge eating. Furthermore, for the overeating group in comparison to controls, fasting behavior was associated with higher odds of overeating. For the psychiatric variables, the binge-eating and overeating groups were associated with higher rates of compulsive buying when compared to healthy controls. Additionally, the overeating group was associated with higher rates of alcohol dependence. Lastly, binge-eating and overeating behaviors were positively associated with specific psychiatric and health comorbidities. Further research is needed to inform the development of effective treatments for disordered eating problems, as evidenced by an anticipated increase of veterans entering the VA healthcare system and the high rate of binge eating observed in our study and prior research in Post-9/11 veterans. Moreover, our study findings suggest the relevance of screening veterans for compulsive buying. This study was limited by its relatively small sample which only examined disordered eating behaviors. Future studies could simultaneously explore binge-eating behaviors and binge-eating disorder diagnoses in larger samples. Study strengths include a diverse sample of Post-9/11 veterans with sizable female representation.

Supplemental Material for Socially Prescribed Perfectionism Predicts Next-Day Binge Eating Behaviors Over 20-Days

Supplemental Material for Socially Prescribed Perfectionism Predicts Next-Day Binge Eating Behaviors Over 20-Days

Binge Eating and Binge Drinking in Emerging Adults During COVID-19 Lockdown in Italy: An Examination of Protective and Risk Factors

This study investigated binge behaviors during COVID-19 lockdown in Italy, exploring individual and contextual risk factors. Participants were 1925 emerging adults ( M age = 24.18, SD age = 2.75; 71.9% women), recruited during the national lockdown in Italy. An online survey investigated binge behaviors both prior and during quarantine. Binge drinking significantly diminished during quarantine, while binge eating episodes did not vary in frequency. However, participants with pre-existent binge eating disorder (BED) reported a worsening in BED symptoms. Lower education, lower SES, job suspension due to lockdown, and higher pandemic-related stress were associated to an increase in binge behaviors during home confinement, whereas living with family was a protective factor. Participants reporting co-occurrent binge behaviors also had significantly higher pandemic-related stress and lower perceived support during home confinement, in comparison with no-binge participants. The study provides new insights about protective and risk factors for binge behaviors in emerging adults during COVID-19 lockdown.

Characterizing behavior change techniques used in the self-management of binge eating and weight: Applying a user-centered design approach

User-centered design methods aim to increase intervention engagement by focusing on consumers' needs and preferences. We conducted a needs assessment (the first step in user-centered design) via a digital diary study to understand how individuals with recurrent binge eating (≥12 episodes in 3 months) and obesity (BMI ≥30 kg/m2) manage these problems in their day-to-day lives and the approaches they use to change their behavior. Specifically, we applied the Behavior Change Technique (BCT)-Taxonomy to characterize which standardized BCTs individuals use to change binge eating and health-related behaviors and their motivations to use them, to inform the design of a mobile intervention. We analyzed qualitative data from 22 adults (64% female, 32% White) who submitted 176 diary entries. For each entry, we coded the BCTs used, motivation for use, and whether the BCT(s) were perceived as beneficial for behavior change. Across participants, investigators identified 50 of the 93 standardized BCTs (54%). Each participant used an average of 12 (SD = 4) BCTs, most commonly Behavior Substitution (72.3%), Distraction (68.2%), Goal Setting (Behavior) (63.6%), Action Planning (59.1%) and Adding Objects to the Environment (59.1%). More BCTs were coded as beneficial (49%) versus detrimental (24%) or neutral (27%). Techniques were most commonly motivated by preventing binge eating (95.5%), losing weight (95.5%), reducing unhealthy food choices (90.9%), or managing stress (59.1%). Results help inform how interventions could be designed to support consumers in changing binge eating and weight-related behaviors, although such designs would need to be tested for their impact on engagement and outcomes.

Role of Nociceptin/Orphanin FQ-NOP Receptor System in the Regulation of Stress-Related Disorders

Nociceptin/orphanin FQ (N/OFQ) is a 17-residue neuropeptide that binds the nociceptin opioid-like receptor (NOP). N/OFQ exhibits nucleotidic and aminoacidics sequence homology with the precursors of other opioid neuropeptides but it does not activate either MOP, KOP or DOP receptors. Furthermore, opioid neuropeptides do not activate the NOP receptor. Generally, activation of N/OFQ system exerts anti-opioids effects, for instance toward opioid-induced reward and analgesia. The NOP receptor is widely expressed throughout the brain, whereas N/OFQ localization is confined to brain nuclei that are involved in stress response such as amygdala, BNST and hypothalamus. Decades of studies have delineated the biological role of this system demonstrating its involvement in significant physiological processes such as pain, learning and memory, anxiety, depression, feeding, drug and alcohol dependence. This review discusses the role of this peptidergic system in the modulation of stress and stress-associated psychiatric disorders in particular drug addiction, mood, anxiety and food-related associated-disorders. Emerging preclinical evidence suggests that both NOP agonists and antagonists may represent a effective therapeutic approaches for substances use disorder. Moreover, the current literature suggests that NOP antagonists can be useful to treat depression and feeding-related diseases, such as obesity and binge eating behavior, whereas the activation of NOP receptor by agonists could be a promising tool for anxiety.