Explanatory models for eating disorders have changed over time to account for changing clinical presentations. The transdiagnostic model evolved from the maintenance model, which provided the ...framework for cognitive behavioural therapy for bulimia nervosa. However, for many individuals (especially those at the extreme ends of the weight spectrum), this account does not fully fit. New evidence generated from research framed within the food addiction hypothesis is synthesized here into a model that can explain recurrent binge eating behaviour. New interventions that target core maintenance elements identified within the model may be useful additions to a complex model of treatment for eating disorders.
Objectives
To assess the level of deterioration in functioning of ED patients during confinement, due to COVID‐19, and examine potential contributing factors (coping strategies, anxiety‐depressive ...symptomatology and personality traits).
Methods
A total of 74 ED patients in treatment before the COVID‐19 outbreak, contributed to this study. Baseline pre‐treatment evaluation included the SCL‐90R, TCI‐R, EDI‐2 and Y‐FAS 2.0 questionnaires for general psychopathology, personality and ED severity indexes. ED symptoms, coping strategies, socio‐demographic data and COVID‐19 concerns were collected by clinicians through a semi‐structured telephone survey during lockdown.
Results
A deterioration in ED symptoms and general psychopathology (anxiety and depression), during lockdown, was associated with low self‐directedness. Higher ED symptomatology during confinement was associated with less‐adaptive coping strategies to deal with lockdown situation leading to an increase in weight.
Conclusions
These specific vulnerability factors to further confinement or stressful situations may help design personalized preventive and therapeutic approaches.
Extreme weight conditions (EWC) groups along a continuum may share some biological risk factors and intermediate neurocognitive phenotypes. A core cognitive trait in EWC appears to be executive ...dysfunction, with a focus on decision making, response inhibition and cognitive flexibility. Differences between individuals in these areas are likely to contribute to the differences in vulnerability to EWC. The aim of the study was to investigate whether there is a common pattern of executive dysfunction in EWC while comparing anorexia nervosa patients (AN), obese subjects (OB) and healthy eating/weight controls (HC).
Thirty five AN patients, fifty two OB and one hundred thirty seven HC were compared using the Wisconsin Card Sorting Test (WCST); Stroop Color and Word Test (SCWT); and Iowa Gambling Task (IGT). All participants were female, aged between 18 and 60 years.
There was a significant difference in IGT score (F(1.79); p<.001), with AN and OB groups showing the poorest performance compared to HC. On the WCST, AN and OB made significantly more errors than controls (F(25.73); p<.001), and had significantly fewer correct responses (F(2.71); p<.001). Post hoc analysis revealed that the two clinical groups were not significantly different from each other. Finally, OB showed a significant reduced performance in the inhibition response measured with the Stroop test (F(5.11); p<.001) compared with both AN and HC.
These findings suggest that EWC subjects (namely AN and OB) have similar dysfunctional executive profile that may play a role in the development and maintenance of such disorders.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
FNDC5/irisin has been recently postulated as beneficial in the treatment of obesity and diabetes because it is induced in muscle by exercise, increasing energy expenditure. However, recent reports ...have shown that WAT also secretes irisin and that circulating irisin is elevated in obese subjects. The aim of this study was to evaluate irisin levels in conditions of extreme BMI and its correlation with basal metabolism and daily activity. The study involved 145 female patients, including 96 with extreme BMIs (30 anorexic (AN) and 66 obese (OB)) and 49 healthy normal weight (NW). The plasma irisin levels were significantly elevated in the OB patients compared with the AN and NW patients. Irisin also correlated positively with body weight, BMI, and fat mass. The OB patients exhibited the highest REE and higher daily physical activity compared with the AN patients but lower activity compared with the NW patients. The irisin levels were inversely correlated with daily physical activity and directly correlated with REE. Fat mass contributed to most of the variability of the irisin plasma levels independently of the other studied parameters. Conclusion. Irisin levels are influenced by energy expenditure independently of daily physical activity but fat mass is the main contributing factor.
Abstract Background Food addiction has been widely researched in past years. However, there is a debate on the mechanisms underlying addictive eating and a better understanding of the processes ...associated to these behaviors is needed. Previous studies have found characteristic psychological correlates of food addiction, such as high negative urgency, emotion regulation difficulties and low self-directedness, in different samples of adults with addictive eating patterns. Still, it seems difficult to disentangle effects independent from general eating disorder psychopathology. Therefore, this study aimed to test a comprehensive model under control of eating disorder severity, in order to find independent predictors of food addiction. Methods 315 patients with eating disorder diagnoses on the binge-eating spectrum were assessed in personality, emotion regulation, negative urgency, eating disorder symptomatology, and food addiction by self-report. Hypothesis-driven structural equation modeling was conducted to test the comprehensive model. Results The only independent predictor found for food addiction was negative urgency, while self-directedness and emotion regulation predicted negative urgency and were highly related to eating disorder symptomatology, but not to food addiction. Conclusions Altogether the model suggests that low self-directedness and difficulties in emotion regulation are related to higher eating disorder symptomatology in general. Those patients who, in addition to these traits, tend to act impulsively when in negative mood states, are at risk for developing addictive eating patterns. Urgency-based treatments are therefore recommended for this subgroup of patients.
Background: Functional magnetic resonance imaging (fMRI) has provided insight on
how neural abnormalities are related to the symptomatology of the eating disorders (EDs): anorexia
nervosa (AN), ...bulimia nervosa (BN), and binge eating disorder (BED). More specifically, an increasingly
growing number of brain imaging studies has shed light on how functionally connected
brain networks contribute not only to disturbed eating behavior, but also to transdiagnostic alterations
in body/interoceptive perception, reward processing and executive functioning.
Methods: This narrative review aims to summarize recent advances in fMRI studies of patients with
EDs by highlighting studies investigating network alterations that are shared across EDs.
Results and Conclusion: Findings on reward processing in both AN and BN patients point to the
presence of altered sensitivity to salient food stimuli in striatal regions and to the possibility of hypothalamic
inputs being overridden by top-down emotional-cognitive control regions. Additionally,
innovative new lines of research suggest that increased activations in fronto-striatal circuits are
strongly associated with the maintenance of restrictive eating habits in AN patients. Although significantly
fewer studies have been carried out in patients with BN and BED, aberrant neural responses
to both food cues and anticipated food receipt appear to occur in these populations. These
altered responses, coupled with diminished recruitment of prefrontal cognitive control circuitry, are
believed to contribute to the binge eating of palatable foods. Results from functional network connectivity
studies are diverse, but findings tend to converge on indicating disrupted resting-state
connectivity in executive networks, the default-mode network and the salience network across EDs.
Anorexia nervosa and bulimia nervosa are eating disorders associated with life-threatening multisystemic medical complications. This narrative review aimed to present the medical complications most ...related to these disorders. In anorexia nervosa, many of them are linked to malnutrition and underweight, usually reversible with renutrition and weight restoration, although refeeding can also be linked to some medical complications. Purging behaviors observed in the anorexia nervosa binge-purging subtype and bulimia nervosa have been mainly related to hydrolectrolyte and acid-base disturbances, in addition to local complications. Thus, an early identification and therapeutic intervention of these disorders is considered crucial. Integral medical monitoring should be ensured to prevent potential serious complications from the early stages, with the involvement of physicians, psychologists, nutritionists, and other specialists in a multidisciplinary approach according to the patient's needs.
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