Episodes Of Overeating Research Articles

Irritable bowel syndrome phenotypes: leading factors of genetics and epigenetics, mechanisms of formation

To develop individualized approaches to the treatment of irritable bowel syndrome (IBS) based on the interaction of genetic and epigenetic factors, to characterize the phenotypes of the disease. According to the formulated concept of the authors, from the cohort of patients with IBS, subgroups were distinguished - "post-infectious IBS" (n=45), "IBS in overweight and obese people" (n=49), "comorbid IBS" (n=75) and "essential IBS" (n=51). In each subgroup the prevalence of candidate gene polymorphisms associated with IBS (COMT, SLC6A4, FTO), nutritional habits, levels of anxiety and depression, secretion of cortisol, serotonin, dopamine and zonulin levels in feces were studied. Patients with "post-infectious IBS" are characterized by the carriage of the S allele of the SLC6A4 gene, the val/val genotype of the COMT gene, the prevalence of diarrhea, a high level of anxiety and frequent refusal of milk and dairy products. The phenotype "IBS in overweight and obese individuals" is characterized by L/L genotypes of the SLC6A4 gene, met/met of the COMT gene and A/A of the FTO gene, constipation, low plasma dopamine levels, signs of depression, frequent episodes of overeating, addiction to fatty and sweet foods, excessive consumption of sugar, lack of vegetables in the diet. The "comorbid IBS phenotype" is characterized by more frequent detection of the val/val genotype of the COMT gene and the carriage of the S allele of the SLC6A4 gene, clinically pronounced anxiety and depression, early onset of the disease, severe course, significant food restrictions and significant increase in epithelial permeability. With the "essential phenotype", there are no bright stigmas of the disease; it is not possible to identify distinctive genetic and epigenetic factors, as well as the leading pathogenetic mechanism. The analysis of genetic and epigenetic factors, the leading mechanisms of the formation and course of IBS allows us to identify additional (except for "postinfectious") phenotypes of the disease: "IBS in overweight and obese people", "comorbid" and "essential".

Генетические факторы и течение синдрома раздраженного кишечника: ассоциации и взаимосвязи

Aim: to evaluate the effect of the interaction of genetic and epigenetic factors on the formation and persistence of signs concerning irritable bowel syndrome (IBS). Patients and Methods: the study included 263 patients with IBS (189 female, 74 male, mean age — 29 [25; 35] years), including: IBS with diarrhea (n=84), IBS with constipation (n=92), mixed IBS (n=87); mild (n=110), moderate (n=99), severe (n=54) course. The control group consisted of 40 subjects comparable by gender and age. In each group, the polymorphism prevalence of candidate genes associated with IBS (COMT, DRD2, SLC6A4, LCT, FTO, TLR9), nutritional characteristics, the level of anxiety and depression, including specific gastrointestinal anxiety, life quality, cortisol content in saliva, blood serotonin, dopamine blood level, fecal zonulin. Results: Val/Val genotype of the COMT gene, characterized by high enzyme activity, was more common among patients with IBS with diarrhea and mixed IBS (χ2=55.75, p<0.001), in severe course (χ2=32.66, p<0.001) and was associated with diarrhea (χ2=53.39, p<0.001), anxiety (χ2=20.01, p<0.001); Met/Met genotype was associated with constipation (χ2=16.09, p<0.001), abdominal pain (χ2=11.04, p=0.004) and depression (χ2=13.12, p=0.001). T/T genotype of the DRD2 gene, leading to a decrease in the density of dopamine D2 receptors, was more commonly found in patients with IBS with constipation (χ2=13.05, p=0.042) and severe course (χ2=30.37, p<0.001), and was associated with abdominal pain (χ2=42.84, p<0.001), episodes of overeating (χ2=29.05, p<0.001), sugar cravings (χ2=16.82, p=0.002) and depression (χ2=39.63, p<0.001). S/S genotype of the SLC6A4 gene, leading to a decrease in serotonin reuptake, was more common in patients with IBS with diarrhea (χ2=28.77, p<0.001), and was associated with abdominal pain (χ2=9.15, p<0.001), diarrhea (χ2=39.98, p<0.001) and anxiety (χ2=7.87, p=0.02), genotype L/L — with constipation (χ2=12.4, p=0.002). A/A genotype of the FTO gene was associated with overweight (χ2=41.33, p<0.001), episodes of overeating (χ2=31.49, p<0.001), increased consumption of added sugar (χ2=9.25, p=0.010), and cravings for sweet (χ2=26.19, p=0.001), farinaceous and confectionery products (χ2=7.85, p=0.019). CC genotype of the TLR9 gene, leading to excessive activation of TLR9, was more commonly detected in individuals with a history of acute intestinal infection (χ2=8.45, p=0.038). Conclusion: the identified associations suggest the impact of genetic and environmental factors on the severity and nature of the IBS course. KEYWORDS: irritable bowel syndrome, genetic factors, epigenetic factors, catechol-O-methyltransferase, dopamine D2 receptors, serotonin reuptake transporter, fat mass and obesity-associated gene, LCT gene, toll-like receptors. FOR CITATION: Gaus O.V., Livzan M.A. Genetic factors and the course of irritable bowel syndrome: associations and interactions. Russian Medical Inquiry. 2023;7(5):237–248 (in Russ.). DOI: 10.32364/2587-6821-2023-7-5-1.

Affective responses to overeating episodes in women participating in a behavioral weight loss program

BackgroundMuch research has focused on precursors to dietary lapses in weight loss programs, but less is known about how individual responses to lapses may influence future non-adherence and program success. The current study examined affective responses to overeating lapses and their influence on subsequent overeating and overall weight loss. MethodsWomen (n = 60) with overweight or obesity (BMI (mean ± SD): 34.3 ± 3.9 kg/m2; age: 48.1 ± 10.1 years) participated in a 3-month group behavioral weight loss intervention (BWLI). At baseline and 3 months, participants completed anthropometric assessments and a 10-day ecological momentary assessment protocol sent 5 times per day reporting on overeating and affect (stress, shame, anxiety, and feeling good about oneself). Across time points, multilevel models were used to examine affective responses to overeating and to predict likelihood of subsequent overeating. Linear regression models were used to examine the effect of affective responses to overeating (at baseline and collapsed across time points) on weight loss. ResultsFollowing self-reported overeating episodes, compared to non-overeating episodes, feeling good about oneself decreased. These decreases lessened with time from overeating. Overeating predicted subsequent overeating episodes, with decreases in feeling good about oneself following overeating marginally predicting increased likelihood (p = 0.065). Neither overeating frequency at baseline nor change in overeating frequency predicted weight loss; however, greater decreases in anxiety following overeating were associated with less weight loss. ConclusionsSelf-reported overeating during a BWLI was associated with negative affective responses and may have increased the likelihood of subsequent overeating, but did not affect overall weight loss in this sample.

Changes in eating and exercise behaviors during the COVID-19 pandemic in a community sample: A retrospective report

ObjectiveThe COVID-19 pandemic has generated extreme physical, psychological, and social consequences across the world, many of which have the potential to exacerbate disordered eating and exercise behaviors. The purpose of this study was to retrospectively assess changes in eating pathology and exercise behaviors as a result of the COVID-19 pandemic in a community sample. MethodParticipants (n = 159, Mage = 27.59 years, 90.6% female) were individuals in the United States surveyed during COVID-19. Participants completed measures quantifying eating pathology, exercise behaviors, and motives for exercise both prior to and during the pandemic. ResultsAll results compare variables prior to and during COVID-19. Overall, individuals with a prior eating disorder (ED) diagnosis did not report significantly different changes in eating or exercise pathology compared to the non-ED group. Participants had significantly fewer episodes of overeating (p < .05, d = −0.23) and eating with loss of control (p < .05, d = −0.23), but not objective binge episodes. Respondents also indicated an overall decrease in time spent on strength/weight activity (p < .05, d = −0.34) and increase in cardiovascular activity (p < .05, d = 0.19), as well as significant changes in motives for exercise. DiscussionOur results suggest that in a sample of primarily young adult females, with and without a prior ED, exercise behaviors and motives, but not eating pathology, shifted significantly in the first few months of the COVID-19 pandemic. Further longitudinal studies examining the maintenance and potential risk of these changes are warranted, particularly in individuals at high risk, as the pandemic continues.

Psychopathological consequences and dysfunctional behaviours during the COVID-19 epidemic in italy: A longitudinal study before and after the lockdown

IntroductionIn the first months of 2020 the COVID-19 epidemic spread in Italy, and the Italian government implemented a general lockdown. These events are at high risk for psychiatric symptoms in the general population, including anxiety/depression and post-traumatic stress symptoms (PTSS).ObjectivesTo characterize the psychopathological correlates of the spread of COVID-19 and lockdown in a sample of subjects from the Italian population, with a before-after follow-up.MethodsSix weeks after the lockdown, 671 subjects aged 18-60 years completed the Brief Symptom Inventory and Impact of Event Scale-Revised, for the evaluation of psychopathology and PTSS respectively. Environmental factors and subjectively-perceived deteriorations related to COVID-19 were also investigated. Pre-COVID-19 data on psychopathology, collected in December 2019/January 2020, were available for 130 subjects and were used for longitudinal analyses.ResultsWith respect to males, female subjects more frequently reported deteriorations of relations (21.5% vs 10.9%), household arguments (26.0% vs 12.6%), sleep quality (47.6% vs 26.6%), episodes of overeating (22.5% vs 12.5%), worries for oneself (19% vs 8.9%) and for loved ones (55.7% vs 36.5%). These changes were associated with increased psychopathology, PTSS, and numerous environmental conditions, including significant economic damage from COVID-19/lockdown. Longitudinal analyses showed an increase in phobic anxiety in the whole sample, and in depression for female subjects only, following the spread of COVID-19. Pre-existing psychopathology was a significant predictor of PTSS.ConclusionsCOVID-19 epidemic and lockdown have a high impact on psychopathology and PTSS. Female subjects and those with pre-existing psychopathology were found to be more vulnerable and may need additional support.DisclosureNo significant relationships.

Altered regional grey matter volume and appetite-related hormone levels in adolescent obesity with or without binge-eating disorder.

Binge eating disorder (BED) is characterized by frequent and persistent overeating episodes of binge eating without compensatory behaviors. The aim was to evaluate regional gray matter volume (GMV) abnormalities and appetite-regulating hormone levels (NPY and Leptin) in obese subjects either with or without BED compared to healthy controls (HC). Twenty-six obese patients with BED, 25 obese patients without BED and 27 healthy subjects as an age-matched control group with neuroimaging and appetite-regulating hormone levels were found eligible for regional GMV abnormalities. A structural magnetic resonance scan and timely blood samples were drawn to assess the appetite-regulating hormone levels. The BED obese patients had a greater GMVs of the right medial orbitofrontal cortex (OFC) and the left medial OFC compared to the non-BED obese patients. BED patients were characterized by greater GMV of the left medial OFC than HCs. Relative to the HCs, higher serum NPY levels were found in BED obese and non-BED obese groups. Serum leptin levels (pg/mL) had positively correlations with GMV in right medial OFC, left medial OFC, right lateral OFC, and left anterior cingulate cortex. Among the reward processing network, which is largely associated with feeding behaviours in individuals with obesity and binge eating disorder, the OFC volumes was correlated with serum leptin concentrations. The results of our study may provide a rationale for exploring the link between regional grey matter volumes and appetite-related hormone levels in people with BED. Level III, case-control analytic study.

Risk factors for eating disturbance in adolescent girls with dysregulation of the menstrual cycle

Summary.The article presents the results of eating behavior and personality traits study in a group of adolescent girls who consulted a gynecologist in connection with menstrual irregularities.The aimof the study was to identify risk factors for eating disturbance in adolescent girls with menstrual dysregulation.Materials and methods:were examined 75 adolescent girls with various disorders of the menstrual cycle (amenorrhea, opsooligomenorrhea, menorrhagia) and 25 girls of the control group. The characteristic features of eating disorders, the degree of dissatisfaction with one’s appearance, the level of self-esteem, various aspects of self-attitude, the severity of perfectionism and the level of anxiety were assessed. The main factors that determine the relationship between eating behavior and personal characteristics were identified using factor analysis. Risk factors for the development of the main symptoms of eating disorders (drive for thinness and bulimia) in adolescent girls were assessed using regression analysis.Results.It was found that girls with menstrual irregularities are more prone to episodes of overeating and the use of cleansing procedures, they have lower self-esteem and a more negative self-attitude. There were no significant differences in the girls’ assessment of their body image depending on the presence or absence of menstrual irregularities, as well as on the type of disturbances. This assessment in all cases had a tendency to negative perception of varying severity. Factor analysis of indicators of eating disturbances and personality traits in the study groups showed that eating disturbances in girls are closely associated with a negative attitude towards their bodies and with indicators of anxiety. Regression analysis identified indicators affecting drive for thinness and bulimic behavior that differed between groups.Conclusion.Eating behavior in adolescent girls is mediated through various psychological characteristics, including those associated with the features of the menstrual cycle.

The effect of restrained eating on acute stress-induced food intake in people with obesity

Restrained eating, defined as a form of intense dieting or restrictive food intake of specific macronutrients or types of food with sporadic episodes of overeating, results in an increased risk of overweight and obesity. Acute stress situations cause irregular eating patterns and are connected to restrained eating. Therefore, the present study investigates the effect of high/low restrained eating on eating behavior in people with obesity after standardized acute stress induction as well as resting condition. Fifty men and women with obesity (BMI: 33.62 ± 3.93 kg/m2) were categorized into high restrained eaters (HRE) and low restrained eaters (LRE). The total energy intake was measured during a standardized laboratory meal after a resting and stress condition (Trier Social Stress Test) on two separate days. HRE and LRE showed differences in the total energy intake in response to acute stress but not after resting condition (F(1, 47) = 9.188, p = .004, η2 = 0.164). Lower total energy intake after stress compared to resting condition could be observed in HRE (t (23) = −2.617, p = .015). LRE showed higher total energy intake after stress than after resting condition (t (25) = 2.155, p = .041). The present data suggest that restrained eating behavior might be an influencing factor for stress-induced eating in obesity. It is highly necessary to understand the association between restrained eating behavior, acute stress and obesity for the improvement of the behavioral intervention of dietary restriction.

Interrater reliability of the Eating Disorder Examination among postbariatric patients.

Clinical assessment of eating behaviors with patients who undergo bariatric surgery is challenging because of the complexity of symptom presentation postoperatively. The Eating Disorder Examination (EDE) is a widely-used semistructured clinical interview of eating-disorder psychopathology, yet no studies have examined the interrater reliability among postoperative bariatric surgery patients. The present study aimed to examine the interrater reliability of the EDE, and an alternative classification of size-specific thresholds of binge-eating episodes in a postoperative bariatric surgery sample. University School of Medicine, United States. Participants interviewed were a randomly selected subset (n = 20) from a consecutive series of adults seeking treatment for eating concerns after bariatric surgery. Audio-taped interviews were rated independently by 1 of 4 expert raters. Interrater reliability was assessed using intraclass correlation coefficients (ICC) and kappa statistic. ICCs for the original 4 EDE subscales were excellent, ranging from .88 to .98. ICCs for the alternative brief 3 subscales were also excellent, with a range of .78 to .97. ICCs for bariatric loss-of-control eating episodes were in the good to excellent range, with a range of .66 to .99. Kappa agreement for bariatric overeating episodes was moderate (.60). These findings, based on 4 expert raters, suggest that complex eating-disorder psychopathology, as well as the newly proposed eating behavior with size thresholds relevant to bariatric patients, can be reliably assessed. To our knowledge, this is the first study to provide initial evaluation and support for the interrater reliability of the original EDE with additional modified eating categories developed for postbariatric surgery patients.

Characterizing emotional overeating among patients with and without binge-eating disorder in primary care.

Emotional overeating and loss-of-control eating are associated with poorer weight-related and psychiatric outcomes, yet our understanding of the relationship between these variables is limited, particularly among individuals in primary care. This study examined the frequency of emotional overeating and relationship with loss-of-control eating among patients with and without binge-eating disorder (BED) seeking weight loss treatment in primary care. Participants were 131 adults (n = 105 female) with overweight/obesity seeking weight loss treatment in primary care. Participants completed the Eating Disorder Examination (semi-structured interview) and Yale Emotional Overeating Scale, which measures emotional overeating episodes. Height and weight were measured. Mean age and BMI were 47.60 years and 35.31 kg/m2, respectively. BED criteria were met by n = 35 (26.7%) participants. Participants with BED endorsed more frequent emotional overeating episodes compared to those without BED. While total emotional overeating scores were not associated with loss-of-control eating, discrete types of emotional overeating episodes (e.g., loneliness) were associated with loss-of-control eating. Emotional overeating was most often reported in response to loneliness, boredom, or anxiety, which varied by BED status. Most participants endorsed recent episodes of emotional overeating; those with BED endorsed more frequent episodes. Future research examining the impact of emotional overeating on weight loss treatment outcomes is warranted.

Emotional overeating is common and negatively associated with alcohol use in normal-weight female university students

introductionEating in response to specific emotional cues was hitherto investigated in relation to weight gain, eating disorders, and psychiatric and addictive disorders. Given the difficulties in treating established obesity, preventive interventions towards normal-weight subjects could be more appropriate and cost effective. In order to design such interventions, it is important to characterize emotional overeating in normal-weight subjects, especially young women. MethodsFemale university students aged 18–24 years with healthy Body Mass Index (comprised between 18.5 and 24.9) were asked to complete questionnaires while attending a medical consultation. Emotional Eating frequency in the last 28 days was assessed together with data on habitual physical activity, drinking patterns, substance abuse, suspected eating disorders and cognitive/behavioural components of eating. Sociodemographic data and tobacco use were also collected. ResultsHalf of participants reported intermittent Emotional Overeating in the last 28 days, mostly during one to five days in the last 28 days, in response to Anxiety (51.3%), Loneliness (45.1%), Sadness (44.8%), and Happiness (43.6%), and to a lesser extent in response to Tiredness (27.4%) and Anger (14.6%). In multivariate analysis, Distress-Induced Overeating (DIO) correlated positively with inability to resist emotional cues, disordered eating symptoms, and loss of control over food intake. It correlated negatively with moderate and excessive drinking. ConclusionA large proportion of normal-weight female students used intermittent overeating episodes as a time-limited response to emotional states, especially anxiety. DIO was negatively correlated with alcohol use, which suggests two distinct and somewhat exclusive ways of coping with negative emotions. It was higher in the minority of students with disordered eating symptoms and loss of control over food intake, highlighting the need for a systematic screening in all female students entering college.

A qualitative analysis of men's experiences of binge eating

Binge eating disorder (BED) is characterized by recurrent overeating episodes, accompanied by loss of control (LOC), in the absence of compensatory behaviors. The literature supports that men overeat as often or more often than do women, but they are less likely to endorse LOC and other BED symptoms. Thus, rates of BED are lower among men. However, differences in prevalence rates may reflect gender bias in current conceptualizations of eating disorders and BED diagnostic criteria, not necessarily truly lower rates of disordered eating among men. The purpose of this study was to gather detailed information about how men experience overeating and related body image concerns, to identify common themes. The grounded theory approach was utilized to examine narratives from 11 overweight/obese male college students about their experiences with overeating, with results suggesting that overeating is consistent with male gender role, but LOC is not. Other overeating themes included mindless eating, emotional antecedents, negative consequences, unintentional dietary restriction, and social encouragement to overeat. Participants also reported dissatisfaction with their bodies, a desire for their bodies to be both muscular and thin, concerns related to their physical functioning and health, and a distinction between body image and self-worth. Collectively, these themes suggest further study to more fully explore the features and consequences of how disordered eating and body image concerns may manifest among men.

Social patterning of overeating, binge eating, compensatory behaviours and symptoms of bulimia nervosa in young adult women: results from the Australian Longitudinal Study on Women's Health.

To study social patterning of overeating and symptoms of disordered eating in a general population. A representative, population-based cohort study. The Australian Longitudinal Study on Women's Health (ALSWH), Survey 1 in 1996 and Survey 2 in 2000. Women (n 12 599) aged 18-23 years completed a questionnaire survey at baseline, of whom 6866 could be studied prospectively. Seventeen per cent of women reported episodes of overeating, 16 % reported binge eating and 10 % reported compensatory behaviours. Almost 4 % of women reported symptoms consistent with bulimia nervosa. Low education, not living with family, perceived financial difficulty (OR=1·8 and 1·3 for women with severe and some financial difficulty, respectively, compared with none) and European language other than English spoken at home (OR=1·5 for European compared with Australian/English) were associated with higher prevalence of binge eating. Furthermore, longitudinal analyses indicated increased risk of persistent binge eating among women with a history of being overweight in childhood, those residing in metropolitan Australia, women with higher BMI, smokers and binge drinkers. Overeating, binge eating and symptoms of bulimia nervosa are common among young Australian women and cluster with binge drinking. Perceived financial stress appears to increase the risk of binge eating and bulimia nervosa. It is unclear whether women of European origin and those with a history of childhood overweight carry higher risk of binge eating because of genetic or cultural reasons.

Trastornos de la conducta alimentaria

The main eating disorders (ED) are anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). AN is defined as the refusal to maintain a minimally normal body weight, fear of gaining weight and body image disturbance. BN is characterized by recurrent over-eating episodes with feeling of loss of control, followed by compensatory behaviors. In BED similar episodes of overeating are presented, but without any compensatory behavior. Obesity is not officially an ED, but treating it as such could lead to promising new therapeutic options.Spanish lifetime prevalence of eating disorders is estimated from 4.1 to 6.41%. The clinic will depend on the severity of the disorder and the evolutionary state, organic complications are common and can endanger life, and the underlying psychiatric comorbidity is common. The diagnostic criteria are established by the DSM-5 and ICD-10. Psycho-pharmacological and psycho-therapeutic approaches in ED are designed to restore normal nutritional status, normalize eating habits, solve somatic alterations, and treat mental comorbidity, if any.

Neurofeedback reduces overeating episodes in female restrained eaters: a randomized controlled pilot-study.

Overeating episodes, despite of intentions to control weight, are a common problem among women. Recurring episodes of overeating and dietary failure have been reported to result in higher Body Mass Indexes and to induce severe distress even in non-clinical groups. Based on findings from physiological research on eating behavior and craving, as well as previous biofeedback studies, we derived a cue exposure based EEG neurofeedback protocol to target overeating episodes. The treatment was evaluated in a randomized controlled trial, comparing a neurofeedback group (NFG; n=14) with a waiting list control group (WLG; n=13) in a sub-clinical sample of female restrained eaters. At post-treatment, the number of weekly overeating episodes and subsequent distress were significantly reduced in the NFG compared to the WLG (p<.01; r>.50). In a 3month follow-up, effects in the NFG remained stable. As secondary outcomes, perceived dietingsuccess was enhanced after the treatment. At follow-up, additional beneficial effects on trait food craving were observed. Altogether, we found preliminary evidence for the cue exposure neurofeedback against overeating episodes in female restrained eaters, although specific effects and underlying mechanisms still have to be explored in future research.

Body‐weight perception and related preoccupations in a large national sample of adolescents

This study aimed to investigate the association between body-weight (BW) perception, weight preoccupation and behaviour, including weight control practices and compulsive over-eating episodes, across gender and actual BW classes. This study used a cross-sectional observational study. A large, nationally representative sample of 6404 ninth-grade French adolescents was randomly selected from schools throughout France. Weight and height were measured, and BW preoccupation, BW control practices and compulsive over-eating were self-reported using standardized questionnaires. Nearly one-third of adolescents misperceived their BW. Misperception was more frequent among girls than boys (42.2% vs. 27.3%, P < 0.01). Underestimation of BW among overweight adolescents, like BW overestimation among underweight adolescents, was associated with less preoccupation with weight and fewer weight control practices than accurate perception of BW. Normal weight adolescents who overestimated their BW were more likely to declare weight preoccupations (ORa = 8.66 [6.67-11.25]), dieting (ORa = 4.81 [3.68-6.27]) and recurrent compulsive over-eating episodes (ORa = 2.36 [1.72-3.23]) compared with their counterparts who correctly estimated their BW. Our study underlines the role of these associations in each category of actual BW (underweight, normal weight and overweight) in a large national sample.

Heterogeneity moderates treatment response among patients with binge eating disorder.

The purpose of the study was to explore heterogeneity and differential treatment outcome among a sample of patients with binge eating disorder (BED). A latent class analysis was conducted with 205 treatment-seeking, overweight or obese individuals with BED randomized to interpersonal psychotherapy (IPT), behavioral weight loss (BWL), or guided self-help based on cognitive behavioral therapy (CBTgsh). A latent transition analysis tested the predictive validity of the latent class analysis model. A 4-class model yielded the best overall fit to the data. Class 1 was characterized by a lower mean body mass index (BMI) and increased physical activity. Individuals in Class 2 reported the most binge eating, shape and weight concerns, compensatory behaviors, and negative affect. Class 3 patients reported similar binge eating frequencies to Class 2, with lower levels of exercise or compensation. Class 4 was characterized by the highest average BMI, the most overeating episodes, fewer binge episodes, and an absence of compensatory behaviors. Classes 1 and 3 had the highest and lowest percentage of individuals with a past eating disorder diagnosis, respectively. The latent transition analysis found a higher probability of remission from binge eating among those receiving IPT in Class 2 and CBTgsh in Class 3. The latent class analysis identified 4 distinct classes using baseline measures of eating disorder and depressive symptoms, body weight, and physical activity. Implications of the observed differential treatment response are discussed.

Parent and Family Associations With Weight-Related Behaviors and Cognitions Among Overweight Adolescents

To examine parent and family variables in relation to adolescent weight-control and eating behaviors, body satisfaction, and importance of thinness among overweight adolescents. This study examined parent-reported use of weight-control behaviors (i.e., healthy and unhealthy behaviors, behavioral changes, other diet strategies), parent psychosocial functioning (i.e., depression, self-esteem, body satisfaction, importance of thinness), and family functioning (i.e., cohesion and adaptability) in relation to adolescent weight-control and eating behaviors, body satisfaction, and importance of thinness. Surveys were completed by 103 overweight (body mass index, >or=85th percentile) adolescents (aged 12-20 yr), and their parents. Height and weight were also measured. Linear regression equations were used for continuous outcomes and logistic regression equations for dichotomous outcomes. Adolescent report of lower body satisfaction and engagement in more "severe" or less healthy forms of weight-control behavior were associated with parent weight-control behaviors. Adolescent report of overeating was associated with lower scores of family cohesion and adaptability. Adolescent report of lower body satisfaction was positively associated with parent report of body satisfaction and self-esteem. Adolescent report of greater importance placed on thinness was associated with parent report of lower self-esteem. Findings indicate that several parent and family variables are associated with weight-control behaviors, episodes of overeating, and body satisfaction and importance of thinness among overweight adolescents. Parent weight-control behaviors and adolescent cognitions about body image may be important variables to target within intervention research and treatment programs for overweight youth.

Self-Management Behaviors, Racial Disparities, and Glycemic Control Among Adolescents With Type 2 Diabetes

Type 2 diabetes is a growing problem among adolescents, but little is known about self-management behaviors in this population. Our aim was to examine self-management behaviors and glycemic control among adolescents with type 2 diabetes. From 2003 to 2005, a telephone survey of adolescents with type 2 diabetes was performed. Chart review obtained most recent glycated hemoglobin and clinical characteristics. Analyses compared patient characteristics and self-management behaviors to recent glycated hemoglobin levels. Of 139 patients contacted, 103 (74%) completed the study. The mean age was 15.4 years: 69% were girls, 47% were white, and 46% were black. Mean glycated hemoglobin was 7.7%, and the average duration of diabetes was 2.0 years. More than 80% of patients reported > or = 75% medication compliance, and 59% monitored blood glucose > 2 times daily. However, patients reported frequent episodes of overeating, drinking sugary drinks, and eating fast food. More than 70% of patients reported exercising > or = 2 times a week, but 68% reported watching > or = 2 hours of television daily. Nonwhite patients had higher glycated hemoglobin and hospitalizations per year compared with white patients. In multivariable analyses, nonwhite race remained significantly associated with higher glycated hemoglobin even after adjusting for age, gender, BMI, insurance status, and other factors. Nonwhite patients were more likely to watch > or = 2 hours of television per day (78% vs 56%), to report exercising < or = 1 time per week (35% vs 21%), and to drink > or = 1 sugary drink daily (27% vs 13%). Although patients reported good medication and monitoring adherence, they also reported poor diet and exercise habits and multiple barriers. Nonwhite race was significantly associated with poorer glycemic control even after adjusting for covariates. This may, in part, be related to disparities in lifestyle behaviors. Additional studies are indicated to further assess self-management behaviors and potential racial disparities in adolescents with type 2 diabetes.

Comportamento de restrição alimentar e obesidade

A obesidade é uma doença de alta prevalência no mundo e é responsável por sérias repercussões orgânicas e psicossociais, desde a infância até a vida adulta. O comportamento alimentar tem bases biológicas e sociais e, associado, à obesidade, torna-se um processo ainda mais complexo pelos aspectos psicológicos envolvidos, os quais se expressam por meio de humor depressivo, ansiedade, sentimento de culpa e, também, por mecanismos fisiológicos, como a resistência ao jejum na vigência de dietas restritivas. Há evidências de que, em indivíduos obesos, comportamentos de compulsão alimentar e ou restrição são mais freqüentes e parecem ser, em parte, responsáveis pelos fracassos observados no tratamento da obesidade. As restrições e auto-imposições das pessoas que fazem dieta, parecem ter um efeito rebote, resultando em compulsão alimentar, a qual pode associar-se a conseqüências psicológicas, como a perda da auto-estima, mudanças de humor e distração. As reflexões desta revisão sugerem que os programas para redução de peso corporal devem enfocar as bases do comportamento alimentar e desenvolver, efetivamente, ações interdisciplinares que permitam obter resultados eficazes no tratamento da obesidade.