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Eating Disorders and Obesity: The Challenge for Our Times
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Eating Disorders and Obesity: The Challenge for Our Times

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 November 2018) | Viewed by 114474

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Phillipa Hay

E-Mail Website
Guest Editor
Translational Health Research Institute, School Of Medicine, Western Sdyney University, Sydney, Australia
Interests: eating disorders; evidence-based medicine; mental health literacy
Special Issues, Collections and Topics in MDPI journals
Dr. Deborah Mitchison

E-Mail Website
Guest Editor
Macquarie University Research Fellow， Centre for Emotional Health | Department of Psychology， Macquarie University NSW 2109, Australia
Interests: binge eating; bulimia nervosa; obesity; epidemiology

Special Issue Information

Dear Colleagues,

We invite you to contribute your research paper or systematic review/meta-analysis to this Special Issue on “Eating Disorder and Obesity: The Challenge for Our Times”.

Eating Disorders have traditionally been considered apart from public health concerns about increasing obesity. It is evident that these problems are, however, related in important ways. Comorbid obesity and eating disorder is increasing at a faster rate than either obesity or eating disorders alone and one in five people with obesity also presents with an Eating Disorder, commonly but not limited to Binge Eating Disorder. New disorders have emerged such as normal weight or Atypical Anorexia Nervosa. However research and practice too often occurs in parallel with a failure to understand the weight disorder spectrum and consequences of co-morbidity that then contributes to poorer outcomes for people living with a larger size and an Eating Disorder. Urgently needed are trials that will inform more effective assessment, treatment and care where body size and eating disorder symptoms are both key to the research question.

The aim of this Special Issue is to highlight and encourage the dissemination of research that will help scientists and clinicians meet the challenge of how best to integrate and improve the prevention and treatment of both problems. Thus, we encourage papers on the risk factors for and aetiology of comorbid disorders, as well as research on their distribution, prevention and management.  

Prof. Phillipa Hay
Dr. Deborah Mitchison
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Binge eating
  • Obesity
  • Over weight
  • Bulimia nervosa
  • Eating Disorders
  • Atypical anorexia nervosa
  • Feeding disorders
  • Comorbidity
  • Night eating syndrome
  • Anorexia Nervosa
  • Weight loss
  • Dieting

Published Papers (19 papers)

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Editorial

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4 pages, 189 KiB  
Editorial
Eating Disorders and Obesity: The Challenge for Our Times
by Phillipa Hay and Deborah Mitchison
Nutrients 2019, 11(5), 1055; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11051055 - 11 May 2019
Cited by 22 | Viewed by 7713
Abstract
Public health concerns largely have disregarded the important overlap between eating disorders and obesity. This Special Issue addresses this neglect and points to how progress can be made in preventing and treating both. Thirteen primary research papers, three reviews, and two commentaries comprise [...] Read more.
Public health concerns largely have disregarded the important overlap between eating disorders and obesity. This Special Issue addresses this neglect and points to how progress can be made in preventing and treating both. Thirteen primary research papers, three reviews, and two commentaries comprise this Special Issue. Two commentaries set the scene, noting the need for an integrated approach to prevention and treatment. The empirical papers and reviews fall into four broad areas of research: first, an understanding of the neuroscience of eating behaviours and body weight; second, relationships between disordered eating and obesity risk; third, new and integrated approaches in treatment; and fourth, assessment. Collectively, the papers highlight progress in science, translational research, and future research directions. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)

Research

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15 pages, 1055 KiB  
Article
Usability and Engagement Evaluation of an Unguided Online Program for Promoting a Healthy Lifestyle and Reducing the Risk for Eating Disorders and Obesity in the School Setting
by Martina Nitsch, Tanja Adamcik, Stefanie Kuso, Michael Zeiler and Karin Waldherr
Nutrients 2019, 11(4), 713; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11040713 - 27 Mar 2019
Cited by 18 | Viewed by 4745
Abstract
Implementing integrated online prevention to reduce the risk of both obesity and eating disorders, in the school setting, is a promising approach. The challenge is to develop highly user-friendly and motivating programs, to foster adherence and effectiveness. The purpose of this study was [...] Read more.
Implementing integrated online prevention to reduce the risk of both obesity and eating disorders, in the school setting, is a promising approach. The challenge is to develop highly user-friendly and motivating programs, to foster adherence and effectiveness. The purpose of this study was to evaluate the usability of such a universal prevention program for students aged 14–19 years, and to address engagement issues. A mixed-methods approach was chosen, consisting of a think-aloud task, a semi-structured interview, and a questionnaire including items on sociodemographic characteristics and the System Usability Scale (SUS). Usability tests were conducted in two rounds, with five adolescents participating per round. Mean score in the SUS was 92.5 of 100 points (range 85–100), in the second round, after some adaptations from the participants’ feedback. In the course of the think-aloud tasks and interviews, five major themes emerged—visual design, navigation, mode of transfer, content, and engagement conditions. Interesting headlines, gamification, and monitoring tools are crucial for engagement. Apart from the importance of using the program during school hours, the study showed that problems currently perceived as important by the target group, need to be considered and addressed, prior to offering them prevention programs, which highlights the importance of a user-centered design. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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12 pages, 3261 KiB  
Article
Binge-Type Eating in Rats is Facilitated by Neuromedin U Receptor 2 in the Nucleus Accumbens and Ventral Tegmental Area
by Ashley E. Smith, James M. Kasper, Ara 13, Noelle C. Anastasio and Jonathan D. Hommel
Nutrients 2019, 11(2), 327; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11020327 - 02 Feb 2019
Cited by 11 | Viewed by 3909
Abstract
Binge-eating disorder (BED) is the most common eating disorder, characterized by rapid, recurrent overconsumption of highly palatable food in a short time frame. BED shares an overlapping behavioral phenotype with obesity, which is also linked to the overconsumption of highly palatable foods. The [...] Read more.
Binge-eating disorder (BED) is the most common eating disorder, characterized by rapid, recurrent overconsumption of highly palatable food in a short time frame. BED shares an overlapping behavioral phenotype with obesity, which is also linked to the overconsumption of highly palatable foods. The reinforcing properties of highly palatable foods are mediated by the nucleus accumbens (NAc) and the ventral tegmental area (VTA), which have been implicated in the overconsumption behavior observed in BED and obesity. A potential regulator of binge-type eating behavior is the G protein-coupled receptor neuromedin U receptor 2 (NMUR2). Previous research demonstrated that NMUR2 knockdown potentiates binge-type consumption of high-fat food. We correlated binge-type consumption across a spectrum of fat and carbohydrate mixtures with synaptosomal NMUR2 protein expression in the NAc and VTA of rats. Synaptosomal NMUR2 protein in the NAc demonstrated a strong positive correlation with binge intake of a “lower”-fat (higher carbohydrate) mixture, whereas synaptosomal NMUR2 protein in the VTA demonstrated a strong negative correlation with binge intake of an “extreme” high-fat (0% carbohydrate) mixture. Taken together, these data suggest that NMUR2 may differentially regulate binge-type eating within the NAc and the VTA. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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19 pages, 302 KiB  
Article
Orthorexic Tendency in Polish Students: Exploring Association with Dietary Patterns, Body Satisfaction and Weight
by Marta Plichta, Marzena Jezewska-Zychowicz and Jerzy Gębski
Nutrients 2019, 11(1), 100; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11010100 - 05 Jan 2019
Cited by 21 | Viewed by 5618
Abstract
Body dissatisfaction is central to clinically diagnosed eating disorders (ED) and seems to be important in causing other non-clinical disorders, including orthorexia nervosa (ON). It can also affect eating behaviors. The aim of this study was to assess the associations of ON tendency [...] Read more.
Body dissatisfaction is central to clinically diagnosed eating disorders (ED) and seems to be important in causing other non-clinical disorders, including orthorexia nervosa (ON). It can also affect eating behaviors. The aim of this study was to assess the associations of ON tendency with dietary patterns (DPs) and body satisfaction. The data were collected in 2017 through questionnaire survey among 1120 students of health-oriented and other academic programs from seven universities in Poland. Principal components analysis (PCA) was conducted to derive DPs and body satisfaction factors. Six DPs, such as, ‘High-sugar products & snacks’, ‘Fresh products & nuts’, ‘Fatty products & dressings’, ‘Oils & potatoes’, ‘Dairy products & whole-meal bread’, ‘Meat’, and two body satisfaction factors, such as, ‘Bottom body & weight’, and ‘Upper body’ were identified. ON tendency was measured using ORTO-15 questionnaire with both cut-offs, i.e., 35 and 40. Logistic regression analysis was used to verify associations between ON tendency, body satisfaction factors, and DPs. More students of health related majors were characterized by ON tendency in comparison to students of other majors (35.9 vs. 37.2; p < 0.001). More women were dissatisfied with ‘Bottom body & weight compared to men (<0.001). The higher the body mass index (BMI), the more people were dissatisfied with ‘Bottom body & weight’ (p < 0.001). More students with ON tendency were satisfied with their ‘Upper body’ than those without ON tendency, but there were no differences in ON tendency in regard to ‘Bottom body & weight’ satisfaction. ON tendency was associated with more frequent consumption of vegetables, fruits, nuts and seeds, and less frequent consumption of products high in sugar, snacks, fatty products and dressings. Using cut-off at 35 in ORTO-15 seems to be more appropriate than cut-off at 40 to identify external variables describing ON. Future research on orthorexia nervosa should use other research tools than ORTO-15 to better identify individuals with ON and to confirm our findings. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
14 pages, 403 KiB  
Article
Executive Functioning in Obesity, Food Addiction, and Binge-Eating Disorder
by Marie Blume, Ricarda Schmidt and Anja Hilbert
Nutrients 2019, 11(1), 54; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11010054 - 28 Dec 2018
Cited by 42 | Viewed by 8190
Abstract
This study aimed to investigate food addiction (FA) and binge-eating disorder (BED) in their association to executive dysfunctions in adults with obesity. Data on response inhibition, attention, decision-making, and impulsivity were derived from four groups of adults with obesity: obesity and FA ( [...] Read more.
This study aimed to investigate food addiction (FA) and binge-eating disorder (BED) in their association to executive dysfunctions in adults with obesity. Data on response inhibition, attention, decision-making, and impulsivity were derived from four groups of adults with obesity: obesity and FA (n = 23), obesity and BED (n = 19), obesity and FA plus BED (FA/BED, n = 23), and a body mass index-, age-, and sex-stratified control group of otherwise healthy individuals with obesity (n = 23, OB), using established computerized neuropsychological tasks. Overall, there were few group differences in neuropsychological profiles. Individuals of the FA group did not differ from the OB group regarding executive functioning. Individuals with BED presented with significantly higher variability in their reaction times and a deficient processing of feedback for performance improvement compared to individuals of the OB group. Strikingly, individuals with FA/BED did not present neuropsychological impairments, but higher levels of depression than all other groups. The results indicated the presence of a BED-specific neuropsychological profile in the obesity spectrum. The additional trait FA was not related to altered executive functioning compared to the OB or BED groups. Future research is needed to discriminate FA and BED further using food-specific tasks. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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16 pages, 763 KiB  
Article
Neuropsychological and Neurophysiological Indicators of General and Food-Specific Impulsivity in Children with Overweight and Obesity: A Pilot Study
by Ricarda Schmidt, Caroline Sebert, Christine Kösling, Martin Grunwald, Anja Hilbert, Claudia Hübner and Lisa Schäfer
Nutrients 2018, 10(12), 1983; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10121983 - 15 Dec 2018
Cited by 8 | Viewed by 3929
Abstract
Impulsivity, particularly towards food, is a potential risk factor for increased energy intake and the development and maintenance of obesity in children. However, neuropsychological and neurophysiological indicators of general and food-specific impulsivity and their association with children’s weight status are poorly understood. This [...] Read more.
Impulsivity, particularly towards food, is a potential risk factor for increased energy intake and the development and maintenance of obesity in children. However, neuropsychological and neurophysiological indicators of general and food-specific impulsivity and their association with children’s weight status are poorly understood. This pilot study examined electroencephalography (EEG) frequency band profiles during eyes-closed and eyes-open resting state in n = 12 children with overweight or obesity versus n = 22 normal-weight controls and their link to child- and parent-reported and experimentally assessed impulsivity of children (e.g., risk-taking behavior, approach-avoidance behavior towards food). The main results indicated that children with overweight/obesity versus normal weight showed significantly increased delta and decreased alpha band activity during eyes-closed resting state. Across the total sample, EEG slow-wave band activity was particularly linked to self- and parent-reported impulsivity and greater risk-taking behavior, but not to approach behavior towards food, after controlling for children’s age and weight status. The identification of specific EEG patterns in children with excess weight may provide a new basis for developing neurophysiological diagnostic and treatment approaches for childhood obesity. Future studies with larger samples and longitudinal designs are needed to replicate the present findings and test their stability over time. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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13 pages, 663 KiB  
Article
Disordered Eating Attitudes and Behavioral and Neuroelectric Indices of Cognitive Flexibility in Individuals with Overweight and Obesity
by Caitlyn G. Edwards, Anne M. Walk, Sharon V. Thompson, Sean P. Mullen, Hannah D. Holscher and Naiman A. Khan
Nutrients 2018, 10(12), 1902; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10121902 - 04 Dec 2018
Cited by 14 | Viewed by 4046
Abstract
Impairment in cognitive flexibility is a trait characteristic among individuals with diagnosed eating disorders. However, the extent to which these relationships exist in individuals with overweight or obesity remains unclear. Furthermore, there is a lack of knowledge characterizing the neural underpinnings of these [...] Read more.
Impairment in cognitive flexibility is a trait characteristic among individuals with diagnosed eating disorders. However, the extent to which these relationships exist in individuals with overweight or obesity remains unclear. Furthermore, there is a lack of knowledge characterizing the neural underpinnings of these relationships. The current study aimed to investigate disordered eating attitudes and cognitive flexibility among adults with overweight and obesity. The Eating Attitudes Test (EAT-26) and a task-switching paradigm were collected from 132 adults (50 males, Body Mass Index (BMI) = 32.0 ± 5.8 kg/m2). Behavioral measures (accuracy and reaction time (RT)) and neuroelectric indices (amplitude and latency) of the P3 component were assessed. Hierarchical linear regressions, following adjustment of age, sex, intelligence quotient (IQ), weight status, and diet quality were developed using summative and subscale scores of the EAT-26. Higher EAT-26 summative scores, and the Dieting subscale, were related to longer RT. Only the Bulimia and Food Preoccupation subscale was related to longer P3 latency. The relationship between disordered eating attitudes and cognitive flexibility extends to individuals with overweight and obesity and is independent of age, sex, IQ, weight status, and diet quality. These findings are important, as differences in cognitive flexibility can lead to behavioral rigidity. Future work should aim to examine other neuroelectric components to identify where differences driving behavioral latencies may be occurring. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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15 pages, 957 KiB  
Article
Managing Risk of Non-Communicable Diseases in Women with Bulimia Nervosa or Binge Eating Disorders: A Randomized Trial with 12 Months Follow-Up
by Therese Fostervold Mathisen, Jorunn Sundgot-Borgen, Jan H. Rosenvinge and Solfrid Bratland-Sanda
Nutrients 2018, 10(12), 1887; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10121887 - 03 Dec 2018
Cited by 8 | Viewed by 5570
Abstract
Persons with bulimia nervosa (BN) or binge eating disorder (BED) have an elevated risk of non-communicable diseases (NCDs). However, lowering this risk is rarely addressed in standard cognitive-behavioral treatment (CBT). We aimed to compare CBT with an intervention combining physical exercise and dietary [...] Read more.
Persons with bulimia nervosa (BN) or binge eating disorder (BED) have an elevated risk of non-communicable diseases (NCDs). However, lowering this risk is rarely addressed in standard cognitive-behavioral treatment (CBT). We aimed to compare CBT with an intervention combining physical exercise and dietary therapy (PED-t), and hypothesized that the PED-t would do better than CBT in lowering the risk of NCD both initially and longitudinally. In this study, 164 women with bulimia nervosa or binge eating disorder were randomly assigned to 16-weeks of outpatient group therapy with either PED-t or CBT. Body composition (BC) was measured by dual-energy X-ray absorptiometry. Measures of physical fitness (VO2peak and one repetition maximum (1RM) in squats, bench press, and seated row) were also recorded. All measurements were completed baseline, post-treatment, and at 6- and 12-month follow-ups, respectively. Our results showed that PED-t improved more than CBT on mean (99% CI) absolute Vo2peak; 57,2 (84.4, 198.8) mL (g = 0.22, p < 0.001) post-treatment. There were small to medium long-term differences in 1RM after PED-t compared to CBT. BC deteriorated in both groups during follow-up. Neither the PED-t nor the CBT lowered the risk for NCDs. Clearly, other approaches need to be considered to promote physical fitness and lower the risk of NCDs among individuals with BN and BED. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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11 pages, 259 KiB  
Article
Perceived Family Functioning in Relation to Energy Intake in Adolescent Girls with Loss of Control Eating
by Manuela Jaramillo, Natasha L. Burke, Lauren B. Shomaker, Sheila M. Brady, Merel Kozlosky, Jack A. Yanovski and Marian Tanofsky-Kraff
Nutrients 2018, 10(12), 1869; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10121869 - 02 Dec 2018
Cited by 3 | Viewed by 4204
Abstract
Family functioning is hypothesized to influence the development, maintenance, and treatment of obesity and eating disorders. However, there are limited data examining family functioning in relation to energy intake in the laboratory among youth at high-risk for eating disorders and excess weight gain. [...] Read more.
Family functioning is hypothesized to influence the development, maintenance, and treatment of obesity and eating disorders. However, there are limited data examining family functioning in relation to energy intake in the laboratory among youth at high-risk for eating disorders and excess weight gain. Therefore, we examined the relationship between perceived family functioning and energy intake during a laboratory test meal designed to model a binge episode. We performed hierarchical multiple regression analyses among 108 adolescent girls in an excess weight gain prevention trial. Participants were at high-risk for eating disorders and excess weight gain due to reports of loss of control eating (LOC) and high body mass index (BMI). Participants completed the Family Adaptability and Cohesion Scale III to assess family adaptability and cohesion. Following an overnight fast, girls consumed lunch from a laboratory test meal. Poorer family adaptability, but not cohesion, was associated with lower percentage of total energy intake from protein and greater percentage of total energy intake from carbohydrates. Neither adaptability nor cohesion were significantly associated with total intake. We conclude that among girls with LOC eating and high BMI, poor reported family adaptability is associated with greater consumption of obesity-promoting macronutrients during binge episodes. Directionality and temporality of this association between unhealthy consumption and family rigidity requires further study. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
10 pages, 451 KiB  
Article
An Investigation of the Clinical Utility of the Proposed ICD-11 and DSM-5 Diagnostic Schemes for Eating Disorders Characterized by Recurrent Binge Eating in People with a High BMI
by Marly Amorim Palavras, Phillipa Hay and Angélica Claudino
Nutrients 2018, 10(11), 1751; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10111751 - 13 Nov 2018
Cited by 9 | Viewed by 3623
Abstract
The aims of this paper were to compare (1) the proportion of participants diagnosed with threshold or subthreshold Bulimia Nervosa (BN) and Binge Eating Disorder (BED) (clinical utility), and (2) the severity of participants’ clinical features and mental Health-Related Quality of Life (HRQoL) [...] Read more.
The aims of this paper were to compare (1) the proportion of participants diagnosed with threshold or subthreshold Bulimia Nervosa (BN) and Binge Eating Disorder (BED) (clinical utility), and (2) the severity of participants’ clinical features and mental Health-Related Quality of Life (HRQoL) (convergent validity), when diagnosed according to either the Diagnostic and Statistical Manual of Mental Disorders—5th edition (DSM-5) or the proposed International Classification of Diseases 11th edition (ICD-11) schemes. One hundred and seven adult men and women, with a high Body Mass Index (BMI) were evaluated by interview to confirm their eating disorder diagnoses. All participants completed self-report assessments of current symptoms and mental HRQoL. The majority of participants in either diagnostic scheme were included in the main categories of BN or BED (102/107, 95% in the ICD-11 and 85/107, 79% in the DSM-5). Fewer individuals received a subthreshold other or unspecified diagnosis with the ICD-11 compared to the DSM-5 scheme (5% vs. 21%). No significant differences in demographic, clinical features or mental HRQoL of participants with complete or partial BN or BED were found between diagnostic categories. Compared to the DSM-5, the proposed ICD-11 was not over inclusive, i.e., it did not appear to include people with less severe and potentially less clinically relevant symptoms. These results support the greater clinical utility of the ICD-11 whilst both schemes showed convergent validity. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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13 pages, 447 KiB  
Article
Eating Behaviour Predicts Weight Loss Six Months after Bariatric Surgery: A Longitudinal Study
by Kavitha Subramaniam, Wah-Yun Low, Peng-Choong Lau, Kin-Fah Chin, Karuthan Chinna, Nik Ritza Kosai, Mustafa Mohammed Taher and Reynu Rajan
Nutrients 2018, 10(11), 1616; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10111616 - 02 Nov 2018
Cited by 26 | Viewed by 4583
Abstract
Bariatric surgery is currently the most durable weight loss solution for patients with morbid obesity. The extent of weight loss achieved, however, is subject to variation due to various factors, including patients’ behaviour. In this study, we aimed to identify pre- and post-surgical [...] Read more.
Bariatric surgery is currently the most durable weight loss solution for patients with morbid obesity. The extent of weight loss achieved, however, is subject to variation due to various factors, including patients’ behaviour. In this study, we aimed to identify pre- and post-surgical predictors of weight loss following bariatric surgery. This prospective study included 57 participants who went through bariatric surgery (laparoscopic Roux-en-Y gastric bypass: n = 30; laparoscopic sleeve gastrectomy: n = 23; one anastomosis gastric bypass-mini gastric bypass: n = 4) in two tertiary referral hospitals. Consenting participants were assessed prior to surgery (T0), and three months (T1) and six months (T2) after surgery. The assessment included interview and anthropometric measurements. The interview was done with the aid of instruments, including the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression screening and the Dutch Eating Behaviour Questionnaire (DEBQ) for eating behaviour assessment. Baseline comorbidity status was obtained from medical records. A Generalised Estimating Equation (GEE) was developed to determine predictors of weight loss. Participants in the study were mostly women (n = 37, 65%) with a mean age of 39.4 (SD = 10.01) years. The mean excess BMI loss (EBMIL) and total weight loss (TWL) at the sixth month was 63.31% and 23.83%, respectively. Anxiety, depression, and external eating scores reduced over time. Advancing age, high BMI, and higher scores for emotional and external eating emerged as significant negative predictors for TWL%. It can be concluded that the patients experienced substantial weight loss after surgery. Continuous monitoring of psychological well-being and eating behaviour are essential for optimal weight loss. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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16 pages, 286 KiB  
Article
Beliefs about Binge Eating: Psychometric Properties of the Eating Beliefs Questionnaire (EBQ-18) in Eating Disorder, Obese, and Community Samples
by Amy L. Burton, Deborah Mitchison, Phillipa Hay, Brooke Donnelly, Christopher Thornton, Janice Russell, Jessica Swinbourne, Christopher Basten, Mandy Goldstein, Stephen Touyz and Maree J. Abbott
Nutrients 2018, 10(9), 1306; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10091306 - 14 Sep 2018
Cited by 15 | Viewed by 6190
Abstract
Binge eating is a core diagnostic feature of bulimia nervosa, binge eating disorder, anorexia nervosa binge/purge type, and is a common feature of “other specified” and “unspecified” feeding and eating disorders. It has been suggested that specific metacognitive beliefs about food, eating, and [...] Read more.
Binge eating is a core diagnostic feature of bulimia nervosa, binge eating disorder, anorexia nervosa binge/purge type, and is a common feature of “other specified” and “unspecified” feeding and eating disorders. It has been suggested that specific metacognitive beliefs about food, eating, and binge eating may play a key role in the maintenance of binge eating behaviour. The Eating Beliefs Questionnaire (EBQ-18) provides a brief self-report assessment tool measuring three types of metacognitive beliefs: negative, positive, and permissive beliefs about food and eating. This study aimed to build on past research by validating the factor structure and psychometric properties of the EBQ-18 using both a clinical and non-clinical sample. A sample of 688 participants (n = 498 non-clinical participants, n = 161 participants seeking treatment for an eating disorder, and n = 29 participants seeking treatment for obesity) completed a battery of questionnaires, including the EBQ-18 and other measures of eating disorder symptoms and relevant constructs. A subset of 100 non-clinical participants completed the test battery again after an interval of two-weeks, and 38 clinical participants completed the EBQ-18 before and after receiving psychological treatment for their eating disorder. A confirmatory factor analysis (CFA) was conducted and psychometric properties of this measure were assessed. The results of this study provide support for the three-factor model of the EBQ-18. In addition, the EBQ-18 was found to be a valid and reliable measure, with excellent internal consistency, good test-retest reliability in the non-clinical sample, and also demonstrated evidence of sensitivity to treatment in clinical samples with binge eating pathology. Receiver operating characteristic (ROC) curve analyses were used to identify optimal cut-off scores for the EBQ-18. This study provides valuable information about the utility of the EBQ-18 as a measure for use in both clinical and research settings. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
10 pages, 276 KiB  
Article
Cultural Features Influencing Eating, Overweight, and Obesity in the Roma People of South Bohemia
by Věra Olišarová, Valérie Tóthová, Sylva Bártlová, František Dolák, Alena Kajanová, Dita Nováková, Radka Prokešová and Lenka Šedová
Nutrients 2018, 10(7), 838; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10070838 - 28 Jun 2018
Cited by 15 | Viewed by 4175
Abstract
This article describes the important cultural specifics that impact on treatment of overweight and obesity for the Roma people of South Bohemia. Methods: Data on health and nutrition were collected using a semi-structured interview of 302 Roma adults (quantitative phase). A further 25 [...] Read more.
This article describes the important cultural specifics that impact on treatment of overweight and obesity for the Roma people of South Bohemia. Methods: Data on health and nutrition were collected using a semi-structured interview of 302 Roma adults (quantitative phase). A further 25 participants received in-depth interviews regarding their eating and lifestyle habits and perceptions about obesity and overweight (qualitative phase). Height and weight were measured with calibrated scales and stadiometer. Qualitative data were analyzed with the “grounded theory” method. Results: The participants reported a relatively high consumption of high-sugar drinks and foods compared to fruits and vegetables. Lifestyle factors increasing risk of overweight identified from the qualitative interview included unemployment, socially isolating housing, poor transport, poverty, inactivity, tobacco smoking, and for women weight gain after childbirth. Also identified was the need for better health literacy. Conclusions: Effective health education may help to address risk factors for overweight and obesity in Roma peoples. Other measures include improved socioeconomic status and housing security, and improved health literacy of the Roma people. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
23 pages, 314 KiB  
Article
An Exploratory Study Examining Obesity Risk in Non-Obese Mothers of Young Children Using a Socioecological Approach
by Jennifer Martin-Biggers, Virginia Quick, Kim Spaccarotella and Carol Byrd-Bredbenner
Nutrients 2018, 10(6), 781; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10060781 - 17 Jun 2018
Cited by 5 | Viewed by 4357
Abstract
This cross-sectional, exploratory study aimed to (1) develop an obesity risk score using a comprehensive set of variables assessing mothers’ intrapersonal weight-related characteristics and those of their homes’ interpersonal and physical environments, and (2) determine how weight-related characteristics differ by obesity risk level. [...] Read more.
This cross-sectional, exploratory study aimed to (1) develop an obesity risk score using a comprehensive set of variables assessing mothers’ intrapersonal weight-related characteristics and those of their homes’ interpersonal and physical environments, and (2) determine how weight-related characteristics differ by obesity risk level. U.S. mothers (N = 550) of preschool-aged children completed an online survey that assessed maternal self-report weight status, sociodemographics, health-related characteristics, and maternal intrapersonal and their homes’ interpersonal and physical environment weight-related characteristics. Binomial logistic regression analysis identified variables significantly associated with obesity. Scores for all obesity risk variables were summed to create a weighted obesity risk score for non-obese participants (n = 386). Analysis of variance and Tukey post-hoc tests determined how non-obese mothers’ sociodemographic, health-related, and intrapersonal and their homes’ interpersonal and physical environment characteristics differed among obesity risk score tertiles. Results revealed that eight variables explained 53 percent of maternal obesity risk, including African American race, lower education level, more children in household, poorer maternal health, higher weight teasing history, higher body dissatisfaction, primary relative with obesity, and greater concern about children’s overweight risk. Non-obese mothers in the highest obesity risk tertile had greater food insecurity risk, lower family affluence, worse sleep quality, less fruit/vegetable availability, and reported less frequent modeling of healthy behaviors and more family conflict. In conclusion, eight characteristics that explained more than half of the risk for obesity in non-obese mothers of young children, may help healthcare professionals identify mothers at increased risk of obesity and offer preventive care early. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)

Review

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23 pages, 862 KiB  
Review
Food Parenting Practices among Parents with Overweight and Obesity: A Systematic Review
by Chloe Patel, Eleni Karasouli, Emma Shuttlewood and Caroline Meyer
Nutrients 2018, 10(12), 1966; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10121966 - 12 Dec 2018
Cited by 31 | Viewed by 7497
Abstract
Given the links between parental obesity and eating psychopathology in their children, it is important to understand the mechanisms via which unhealthy relationships with eating are passed from generation to generation. The aim was to review research focusing on food-related parenting practices (FPPs) [...] Read more.
Given the links between parental obesity and eating psychopathology in their children, it is important to understand the mechanisms via which unhealthy relationships with eating are passed from generation to generation. The aim was to review research focusing on food-related parenting practices (FPPs) used by parents with overweight/obesity. Web of Science, PubMed and PsycINFO were searched. Studies that included a measure of FPPs were considered eligible and were required to have examined FPPs by parental weight status. Twenty studies were included. Single studies suggest differences between parents with healthy-weight vs. overweight/obesity with respect to; food accessibility, food availability and modelling. Multiple studies suggest that several parenting strategies do not differ according to parental weight status (child involvement, praise, use of food to control negative emotions, use of food-based threats and bribes, pressure, restriction, meal and snack routines, monitoring, and rules and limits). There was inconclusive evidence with respect to differences in parental control, encouragement and use of unstructured FPPs among parents with healthy-weight vs. overweight/obesity. The findings of this review imply some differences between parents with overweight/obesity and healthy-weight and the use of some food-related parenting practices, however, they should be interpreted with caution since research remains limited and is generally methodologically weak. The review highlights opportunities for further research, and suggests improvements to current measures of FPPs. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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17 pages, 801 KiB  
Review
Feedback-Based Treatments for Eating Disorders and Related Symptoms: A Systematic Review of the Literature
by Claudio Imperatori, Miranda Mancini, Giacomo Della Marca, Enrico Maria Valenti and Benedetto Farina
Nutrients 2018, 10(11), 1806; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10111806 - 20 Nov 2018
Cited by 20 | Viewed by 6527
Abstract
The effectiveness of biofeedback and neurofeedback has been investigated in a range of psychiatric disorders. However, to date, there are few studies on the clinical usefulness of feedback-based techniques for eating disorders (EDs) and EDs-related symptoms (e.g., food craving). A systematic search of [...] Read more.
The effectiveness of biofeedback and neurofeedback has been investigated in a range of psychiatric disorders. However, to date, there are few studies on the clinical usefulness of feedback-based techniques for eating disorders (EDs) and EDs-related symptoms (e.g., food craving). A systematic search of PubMed, Scopus and PsychINFO identified 162 articles. Among these, thirteen studies exploring the therapeutic use of biofeedback and neurofeedback in EDs or EDs-related symptoms were included. Biofeedback and neurofeedback were implemented respectively in five and eight of all reviewed articles. No studies incorporated different feedback modalities or both biofeedback and neurofeedback. The considered studies provide preliminary data of the usefulness of feedback-based techniques in the treatment of several dysfunctional eating behaviors (e.g., food craving, rumination). Although no significant effect has been reported for other important EDs-related symptoms (i.e., body image disturbance), feedback-based techniques are also associated with significant modifications of both sympathetic reaction to food-related stimuli and brain activity in several regions of the reward system (e.g., insula). Taken together the results of the present review suggest that feedback-based treatments may be useful in the treatment of several dysfunctional eating behaviors operating both on top-down and bottom-up individual coping strategies. Methodological and clinical issues are also discussed. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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14 pages, 249 KiB  
Review
Energy and Nutrient Issues in Athletes with Spinal Cord Injury: Are They at Risk for Low Energy Availability?
by Katherine Figel, Kelly Pritchett, Robert Pritchett and Elizabeth Broad
Nutrients 2018, 10(8), 1078; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10081078 - 13 Aug 2018
Cited by 25 | Viewed by 5324
Abstract
Low energy availability (LEA) and nutrient intake have been well studied in able-bodied athletes, but there is a lack of research examining these issues amongst athletes with spinal cord injury (SCI). To date, there have been no studies that have examined energy availability [...] Read more.
Low energy availability (LEA) and nutrient intake have been well studied in able-bodied athletes, but there is a lack of research examining these issues amongst athletes with spinal cord injury (SCI). To date, there have been no studies that have examined energy availability (EA) amongst this population. Furthermore, athletes with SCI may experience unique challenges around nutrition that may increase their risk of LEA. This review will evaluate the literature and assess whether this population is at risk for LEA. Due to the limited research on this topic, sedentary individuals with SCI and para athletes were also included in this review. Review of the current literature suggests that athletes with SCI may be at an increased risk for LEA. While research examining EA and risk of LEA in athletes with SCI is lacking, the number of athletes with SCI continues to increase; therefore, further research is warranted to assess nutrient and energy needs and their risk to this population. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)

Other

9 pages, 520 KiB  
Commentary
Shared Concerns and Opportunity for Joint Action in Creating a Food Environment That Supports Health
by Kendrin R. Sonneville and Rachel F. Rodgers
Nutrients 2019, 11(1), 41; https://0-doi-org.brum.beds.ac.uk/10.3390/nu11010041 - 25 Dec 2018
Cited by 5 | Viewed by 4702
Abstract
The food industry is a for-profit industry with high relevance to universal eating disorders prevention. To date, policy which targets the food industry and food environment has been underutilized in efforts to decrease the incidence of eating disorders and associated risk factors. In [...] Read more.
The food industry is a for-profit industry with high relevance to universal eating disorders prevention. To date, policy which targets the food industry and food environment has been underutilized in efforts to decrease the incidence of eating disorders and associated risk factors. In contrast, food policy has been extensively leveraged with the aim of reducing the incidence of obesity. While philosophical misalignments with these later efforts may have constituted an obstacle to identifying the food environment as a key target for eating disorders prevention, food policy is an area where shared interests can be found. Specifically, a shared goal of obesity and eating disorders prevention efforts is creating a food environment that supports health, while minimizing the influence of the food industry that profits from the sale of highly palatable, processed foods and “diet” foods and from increasing portions of foods served and eaten. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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9 pages, 236 KiB  
Commentary
Obesity with Comorbid Eating Disorders: Associated Health Risks and Treatment Approaches
by Felipe Q. Da Luz, Phillipa Hay, Stephen Touyz and Amanda Sainsbury
Nutrients 2018, 10(7), 829; https://0-doi-org.brum.beds.ac.uk/10.3390/nu10070829 - 27 Jun 2018
Cited by 103 | Viewed by 17913
Abstract
Obesity and eating disorders are each associated with severe physical and mental health consequences, and individuals with obesity as well as comorbid eating disorders are at higher risk of these than individuals with either condition alone. Moreover, obesity can contribute to eating disorder [...] Read more.
Obesity and eating disorders are each associated with severe physical and mental health consequences, and individuals with obesity as well as comorbid eating disorders are at higher risk of these than individuals with either condition alone. Moreover, obesity can contribute to eating disorder behaviors and vice-versa. Here, we comment on the health complications and treatment options for individuals with obesity and comorbid eating disorder behaviors. It appears that in order to improve the healthcare provided to these individuals, there is a need for greater exchange of experiences and specialized knowledge between healthcare professionals working in the obesity field with those working in the field of eating disorders, and vice-versa. Additionally, nutritional and/or behavioral interventions simultaneously addressing weight management and reduction of eating disorder behaviors in individuals with obesity and comorbid eating disorders may be required. Future research investigating the effects of integrated medical, psychological and nutritional treatment programs addressing weight management and eating disorder psychopathology in individuals with obesity and comorbid eating disorder behaviors—such as binge eating—is necessary. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: The Challenge for Our Times)
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