To examine whether childhood body mass index (BMI) trajectories are prospectively associated with later eating disorder (ED) diagnoses.
Using a subsample from the Avon Longitudinal Study of Parents ...and Children (N = 1,502), random-coefficient growth models were used to compare premorbid BMI trajectories of individuals who later developed anorexia nervosa (n = 243), bulimia nervosa (n = 69), binge-eating disorder (n = 114), and purging disorder (n = 133) and a control group without EDs or ED symptoms (n = 966). BMI was tracked longitudinally from birth to 12.5 years of age and EDs were assessed at 14, 16, and 18 years of age.
Distinct developmental trajectories emerged for EDs at a young age. The average growth trajectory for individuals with later anorexia nervosa veered significantly below that of the control group before 4 years of age for girls and 2 years for boys. BMI trajectories were higher than the control trajectory for all other ED groups. Specifically, the mean bulimia nervosa trajectory veered significantly above that of controls at 2 years for girls, but boys with later bulimia nervosa did not exhibit higher BMIs. The mean binge-eating disorder and purging disorder trajectories significantly diverged from the control trajectory at no older than 6 years for girls and boys.
Premorbid metabolic factors and weight could be relevant to the etiology of ED. In anorexia nervosa, premorbid low weight could represent a key biological risk factor or early manifestation of an emerging disease process. Observing children whose BMI trajectories persistently and significantly deviate from age norms for signs and symptoms of ED could assist the identification of high-risk individuals.
Risk Factors for Eating Disorders Striegel-Moore, Ruth H; Bulik, Cynthia M
The American psychologist,
04/2007, Letnik:
62, Številka:
3
Journal Article
Recenzirano
The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is ...established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances in understanding the etiology of eating disorders require a new generation of studies that integrate these domains. They discuss how more sophisticated and novel conceptualizations of risk and causal processes may inform both nosology and intervention efforts.
The composition of the gut microbiota in patients with anorexia nervosa (AN), and the ability of this microbial community to influence the host, remains uncertain. To achieve a broader understanding ...of the role of the intestinal microbiota in patients with AN, we collected fecal samples before and following clinical treatment at two geographically distinct eating disorder units (Center of Excellence for Eating Disorders UNC-CH and ACUTE Center for Eating Disorders Denver Health). Gut microbiotas were characterized in patients with AN, before and after inpatient treatment, and in non-eating disorder (non-ED) controls using shotgun metagenomic sequencing. The impact of inpatient treatment on the AN gut microbiota was remarkably consistent between eating disorder units. Although weight in patients with AN showed improvements, AN microbiotas post-treatment remained distinct from non-ED controls. Additionally, AN gut microbiotas prior to treatment exhibited more fermentation pathways and a lower ability to degrade carbohydrates than non-ED controls. As the intestinal microbiota can influence nutrient metabolism, our data highlight the complex microbial communities in patients with AN as an element needing further attention post inpatient treatment. Additionally, this study defines the effects of renourishment on the AN gut microbiota and serves as a platform to develop precision nutrition approaches to potentially mitigate impediments to recovery.
Feeding and eating disorders (FEDs) are common and have been shown to be influenced by both genetic and environmental factors.Avoidant/restrictive food intake disorder, anorexia nervosa (AN), bulimia ...nervosa (BN), and binge-eating disorder (BED) are all heritable and genome-wide association studies (GWASs) reveal both psychiatric and metabolic/anthropometric genetic risk factors for AN. GWASs for other FEDs are underway.AN, BN, and BED might diverge etiologically in their genetic relation with metabolic and anthropometric traits.Functional genomic tools will enable translation of variants to genes, genes to pathways, and pathways to metabolic outcomes to convert genetic findings into medically actionable outcomes. This work is poised to yield the first interventions for FEDs that are informed by disorder-specific biology.
Feeding and eating disorders (FEDs) are heterogenous and characterized by varying patterns of dysregulated eating and weight. Genome-wide association studies (GWASs) are clarifying their underlying biology and their genetic relationship to other psychiatric and metabolic/anthropometric traits. Genetic research on anorexia nervosa (AN) has identified eight significant loci and uncovered genetic correlations implicating both psychiatric and metabolic/anthropometric risk factors. Careful explication of these metabolic contributors may be key to developing effective and enduring treatments for devastating, life-altering, and frequently lethal illnesses. We discuss clinical phenomenology, genomics, phenomics, intestinal microbiota, and functional genomics and propose a path that translates variants to genes, genes to pathways, and pathways to metabolic outcomes to advance the science and eventually treatment of FEDs.
Feeding and eating disorders (FEDs) are heterogenous and characterized by varying patterns of dysregulated eating and weight. Genome-wide association studies (GWASs) are clarifying their underlying biology and their genetic relationship to other psychiatric and metabolic/anthropometric traits. Genetic research on anorexia nervosa (AN) has identified eight significant loci and uncovered genetic correlations implicating both psychiatric and metabolic/anthropometric risk factors. Careful explication of these metabolic contributors may be key to developing effective and enduring treatments for devastating, life-altering, and frequently lethal illnesses. We discuss clinical phenomenology, genomics, phenomics, intestinal microbiota, and functional genomics and propose a path that translates variants to genes, genes to pathways, and pathways to metabolic outcomes to advance the science and eventually treatment of FEDs.
Objective
Suicidality in eating disorders (EDs) is high, and identification of therapeutically targetable traits associated with past, current, and future suicidality is of considerable clinical ...importance. We examined overall and ED subtype‐specific associations among suicidal ideation, suicide attempts, and general and specific aspects of emotion dysregulation in a large sample of individuals with ED, at presentation for treatment and 1‐year follow‐up.
Method
Using registry data from 2,406 patients, scores on the Difficulties in Emotion Dysregulation Scale (DERS) at initial registration were examined as predictors of recent suicidal ideation and self‐report lifetime suicide attempts. Associations were examined in the full sample and in each ED subtype. In 406 patients, initial DERS scores were examined as predictors of suicidality at 1‐year follow‐up.
Results
Overall DERS was associated with suicidal ideation and suicide attempts, even when adjusting for ED psychopathology and current depression. Perceived lack of emotion regulation strategies showed unique associations with suicidal ideation and suicide attempts, both in the full sample and in most ED subtypes. Initial DERS was also associated with follow‐up suicidal ideation and suicide attempts, although this association did not remain when adjusting for past suicidality.
Discussion
Results suggest that emotion dysregulation may be a potential mechanism contributing to suicidality in EDs, beyond the effects of ED psychopathology and current depression. Although the prevalence of suicidality differs across ED subtypes, emotion dysregulation may represent a risk trait for future suicidality that applies transdiagnostically. Results support addressing emotion dysregulation in treatment in order to reduce suicidality.
Background
Immune system dysfunction may be associated with eating disorders (ED) and could have implications for detection, risk assessment, and treatment of both autoimmune diseases and EDs. ...However, questions regarding the nature of the relationship between these two disease entities remain. We evaluated the strength of associations for the bidirectional relationships between EDs and autoimmune diseases.
Methods
In this nationwide population‐based study, Swedish registers were linked to establish a cohort of more than 2.5 million individuals born in Sweden between January 1, 1979 and December 31, 2005 and followed up until December 2013. Cox proportional hazard regression models were used to investigate: (a) subsequent risk of EDs in individuals with autoimmune diseases; and (b) subsequent risk of autoimmune diseases in individuals with EDs.
Results
We observed a strong, bidirectional relationship between the two illness classes indicating that diagnosis in one illness class increased the risk of the other. In women, the diagnoses of autoimmune disease increased subsequent hazards of anorexia nervosa (AN), bulimia nervosa (BN), and other eating disorders (OED). Similarly, AN, BN, and OED increased subsequent hazards of autoimmune diseases.Gastrointestinal‐related autoimmune diseases such as, celiac disease and Crohn's disease showed a bidirectional relationship with AN and OED. Psoriasis showed a bidirectional relationship with OED. The previous occurence of type 1 diabetes increased the risk for AN, BN, and OED. In men, we did not observe a bidirectional pattern, but prior autoimmune arthritis increased the risk for OED.
Conclusions
The interactions between EDs and autoimmune diseases support the previously reported associations. The bidirectional risk pattern observed in women suggests either a shared mechanism or a third mediating variable contributing to the association of these illnesses.
Objective
Alterations in blood lipid concentrations in anorexia nervosa (AN) have been reported; however, the extent, mechanism, and normalization with weight restoration remain unknown. We conducted ...a systematic review and a meta‐analysis to evaluate changes in lipid concentrations in acutely‐ill AN patients compared with healthy controls (HC) and to examine the effect of partial weight restoration.
Method
A systematic literature review and meta‐analysis (PROSPERO: CRD42017078014) were conducted for original peer‐reviewed articles.
Results
Forty‐eight studies were eligible for review; 33 for meta‐analyses calculating mean differences (MD). Total cholesterol (MD = 22.7 mg/dL, 95% CI = 12.5, 33.0), high‐density lipoprotein (HDL; MD = 3.4 mg/dL, CI = 0.3, 7.0), low‐density lipoprotein (LDL; MD = 12.2 mg/dL, CI = 4.4, 20.1), triglycerides (TG; MD = 8.1 mg/dL, CI = 1.7, 14.5), and apolipoprotein B (Apo B; MD = 11.8 mg/dL, CI = 2.3, 21.2) were significantly higher in acutely‐ill AN than HC. Partially weight‐restored AN patients had higher total cholesterol (MD = 14.8 mg/dL, CI = 2.1, 27.5) and LDL (MD = 16.1 mg/dL, CI = 2.3, 30.0). Pre‐ versus post‐weight restoration differences in lipid concentrations did not differ significantly.
Discussion
We report aggregate evidence for elevated lipid concentrations in acutely‐ill AN patients compared with HC, some of which persist after partial weight restoration. This could signal an underlying adaptation or dysregulation not fully reversed by weight restoration. Although concentrations differed between AN and HC, most lipid concentrations remained within the reference range and meta‐analyses were limited by the number of available studies.
Resumen
Objetivo
En la anorexia nervosa (AN) han sido reportadas alteraciones en las concentraciones de lípidos sanguíneos; sin embargo, la extensión, mecanismo y normalización con la restauración del peso continúa aún desconocida. Hicimos una revisión sistemática y meta‐análisis para evaluar los cambios en las concentraciones de lípidos en pacientes agudamente enfermas de AN comparados con controles sanos (HC) y para examinar el efecto parcial de la restauración de peso.
Método
Una revisión sistemática de la literatura y meta‐análisis (PROSPERO: CRD42017078014) fueron llevados a cabo en artículos originales revisados por pares.
Resultados
Un total de cuarenta y ocho estudios fueron elegibles para revisión; 33 para meta‐análisis calculando las diferencias promedio (MD). Colesterol total (MD = 22.7 mg/dL, 95% CI = 12.5, 33.0), lipoproteína de alta densidad (HDL; MD = 3.4 mg/dL, CI = 0.3, 7.0), lipoproteína de baja densidad (LDL; MD = 12.2 mg/dL, CI = 4.4, 20.1), triglicéridos (TG; MD = 8.1 mg/dL, CI = 1.7, 14.5), y apolipoproteína B (Apo B; MD = 11.6 mg/dL, CI = 2.3, 21.2) fueron significativamente elevados en los pacientes agudamente enfermos de AN en comparación con los controles sanos (HC). Los pacientes con AN parcialmente recuperados de peso tuvieron niveles más elevados de colesterol total (MD = 14.8 mg/dL, CI = 2.1, 27.5) y de LDL (MD = 16.1 mg/dL, CI = 2.3, 30.0). Las diferencias pre‐ versus post‐ restauración de peso en las concentraciones de lípidos no difirieron significativamente.
Discusión
Reportamos evidencia agregada de concentraciones elevadas de lípidos en pacientes agudamente enfermos de AN comparados con controles sanos (HC), algunos de los cuales persisten después de la restauración parcial de peso. Esto podría señalar una adaptación subyacente o desregulación no completamente revertida por la restauración del peso. Aunque las concentraciones difirieron entre AN y HC, la mayoría de las concentraciones de lípidos permanecieron dentro del rango de referencia y los meta‐análisis fueron limitados por el número de estudios disponibles.
Turning the tide on obesity? Bulik, Cynthia M; Hardaway, J Andrew
Science (American Association for the Advancement of Science),
08/2023, Letnik:
381, Številka:
6657
Journal Article
Recenzirano
Odprti dostop
Genetics, ultraprocessed foods, portion distortion, sweetened beverages, screen time, food addiction, intestinal microbiota, diet culture, weight stigma, food insecurity-all have been implicated in ...the "obesity epidemic." More than a billion people worldwide have obesity, and many more are overweight. With the emergence of new, highly effective weight-loss drugs, might the "fat decades" become a closed chapter in the history of public health?
Background
Cross‐sectional associations between anxiety disorders and eating disorders (EDs) have been well documented; however, limited research has examined whether symptoms of anxiety disorders ...are prospectively associated with EDs. Identifying these longitudinal associations can aid in discerning relationships among eating and anxiety disorders and point toward a mechanistic understanding of developmental psychopathology. This study investigated the prospective associations between parent‐reported anxiety in mid‐childhood (age 10) and child‐reported ED behaviors and disorders in adolescence (at ages 14 and 16 years) in a population‐based sample.
Methods
Participants were individuals enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population‐based, prospective study of women and their children; 7,767 children whose parents provided data at age 10 were included in current analyses. An exploratory factor analysis identified latent anxiety factors at age 10, followed by a path analysis that evaluated associations between these factors and eating disorder symptoms and cognitions at age 14.
Results
Parent‐reported anxiety symptoms at age 10 yielded 5 factors: obsessive‐compulsive disorder (OCD) symptoms related to symmetry and checking (Factor 1); OCD symptoms associated with aversion to dirt and germs (Factor 2); physical anxiety symptoms (Factor 3); worries (Factor 4); and social phobia symptoms (Factor 5). Factors 3 and 4 showed the most consistent, positive associations with a range of ED symptoms at age 14. Factor 3 predicted diagnosis of bulimia nervosa by age 16 (OR = 1.11, p = .007), whereas Factor 4 predicted diagnoses of anorexia nervosa (OR = 1.10, p = .01) and disordered eating by age 16 (OR = 1.08, p = .001).
Conclusions
Results indicate that symptoms of generalized anxiety in middle childhood may predict adolescent‐onset ED symptoms and ED diagnoses.
Eating behaviours in childhood are considered as risk factors for eating disorder behaviours and diagnoses in adolescence. However, few longitudinal studies have examined this association.
We ...investigated associations between childhood eating behaviours during the first ten years of life and eating disorder behaviours (binge eating, purging, fasting and excessive exercise) and diagnoses (anorexia nervosa, binge eating disorder, purging disorder and bulimia nervosa) at 16 years.
Data on 4760 participants from the Avon Longitudinal Study of Parents and Children were included. Longitudinal trajectories of parent-rated childhood eating behaviours (8 time points, 1.3-9 years) were derived by latent class growth analyses. Eating disorder diagnoses were derived from self-reported, parent-reported and objectively measured anthropometric data at age 16 years. We estimated associations between childhood eating behaviours and eating disorder behaviours and diagnoses, using multivariable logistic regression models.
Childhood overeating was associated with increased risk of adolescent binge eating (risk difference, 7%; 95% CI 2 to 12) and binge eating disorder (risk difference, 1%; 95% CI 0.2 to 3). Persistent undereating was associated with higher anorexia nervosa risk in adolescent girls only (risk difference, 6%; 95% CI, 0 to 12). Persistent fussy eating was associated with greater anorexia nervosa risk (risk difference, 2%; 95% CI 0 to 4).
Our results suggest continuities of eating behaviours into eating disorders from early life to adolescence. It remains to be determined whether childhood eating behaviours are an early manifestation of a specific phenotype or whether the mechanisms underlying this continuity are more complex. Findings have the potential to inform preventative strategies for eating disorders.
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