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Eating Disorders and Obesity: Through the Life Course

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (10 October 2021) | Viewed by 104080

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A printed edition of this Special Issue is available here.

Special Issue Editors

1. Distinguished Professor in Psychology, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
2. Head of Eating Disorders Unit and Head of Research Group CIBEROBN, Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
Interests: clinical psychology; psychobiology; mental disorders; eating disorders; obesity; neurocognition; behavioral addictions; therapy and new technologies
Special Issues, Collections and Topics in MDPI journals
Kings College London, London, UK
Interests: Eating Disorders; anorexia nervosa; family; treatment; bulimia nervosa
1. Head of Pediatric Department, Consorcio Hospital General, University of Valencia, Valencia, Spain
2. CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, Madrid, Spain
Interests: children; adolescents; hypertension; obesity; early origins of non-communicable disease.

Special Issue Information

Dear Colleagues,

Due to the high prevalence of Eating Disorders (ED) and obesity over the life-spam and the increasing comorbidity between both conditions, the goal of this Special Issue, “Eating Disorders and Obesity: Through the Life Course”, is to approach that situation from a broader perspective. We would like to have multidisciplinary contributions, approaching ED and Obesity as potential continuum (eg. Anorexia nervosa and obesity as extreme dimensions), looking not only to shared and differential risk factors (environmental, temperamental, biological, nutritional and neuroendocrinological between ED and obesity), but also to epidemiological studies exploring transition from one to the other, through the life-course, and its impact on the treatment outcome. We are expecting to have systematic reviews and empirical studies (cross-sectional and longitudinal manuscripts), coming from all over the globe.

Prof. Dr. Fernando Fernandez-Aranda
Prof. Janet Treasure
Prof. Dr. Empar Lurbe
Guest Editors

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Keywords

  • Eating Disorders
  • Obesity
  • Childhood
  • Adulthood
  • Elderly
  • Binge eating disorders
  • Bulimia nervosa
  • Risk factors
  • Treatment

Published Papers (19 papers)

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Research

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11 pages, 840 KiB  
Article
Food Addiction in Eating Disorders: A Cluster Analysis Approach and Treatment Outcome
by Lucero Munguía, Anahí Gaspar-Pérez, Susana Jiménez-Murcia, Roser Granero, Isabel Sánchez, Cristina Vintró-Alcaraz, Carlos Diéguez, Ashley N. Gearhardt and Fernando Fernández-Aranda
Nutrients 2022, 14(5), 1084; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14051084 - 04 Mar 2022
Cited by 10 | Viewed by 3186
Abstract
Background: A first approach of a phenotypic characterization of food addiction (FA) found three clusters (dysfunctional, moderate and functional). Based on this previous classification, the aim of the present study is to explore treatment responses in the sample diagnosed with Eating Disorder(ED) of [...] Read more.
Background: A first approach of a phenotypic characterization of food addiction (FA) found three clusters (dysfunctional, moderate and functional). Based on this previous classification, the aim of the present study is to explore treatment responses in the sample diagnosed with Eating Disorder(ED) of different FA profiles. Methods: The sample was composed of 157 ED patients with FA positive, 90 with bulimia nervosa (BN), 36 with binge eating disorder (BED), and 31 with other specified feeding or eating disorders (OSFED). Different clinical variables and outcome indicators were evaluated. Results: The clinical profile of the clusters present similar characteristics with the prior study, having the dysfunctional cluster the highest ED symptom levels, the worse psychopathology global state, and dysfunctional personality traits, while the functional one the lowest ED severity level, best psychological state, and more functional personality traits. The dysfunctional cluster was the one with lowest rates of full remission, the moderate one the higher rates of dropouts, and the functional one the highest of full remission. Conclusions: The results concerning treatment outcome were concordant with the severity of the FA clusters, being that the dysfunctional and moderate ones had worst treatment responses than the functional one. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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12 pages, 331 KiB  
Article
Are Peripheral Biomarkers Determinants of Eating Styles in Childhood and Adolescence Obesity? A Cross-Sectional Study
by Lorena Desdentado, Jaime Navarrete, María Folgado-Alufre, Ana de Blas, Jéssica Navarro-Siurana, Francisco Ponce, Guadalupe Molinari, Andrea Jimeno-Martínez, Azahara I. Rupérez, Gloria Bueno-Lozano, Aida Cuenca-Royo, Emili Corbella, Zaida Agüera, Rosa M. Baños and Julio Álvarez-Pitti
Nutrients 2022, 14(2), 305; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14020305 - 12 Jan 2022
Cited by 1 | Viewed by 1817
Abstract
Disturbances in eating behaviors have been widely related to obesity. However, little is known about the role of obesity-related biomarkers in shaping habitual patterns of eating behaviors (i.e., eating styles) in childhood. The objective of the present study was to explore the relationships [...] Read more.
Disturbances in eating behaviors have been widely related to obesity. However, little is known about the role of obesity-related biomarkers in shaping habitual patterns of eating behaviors (i.e., eating styles) in childhood. The objective of the present study was to explore the relationships between several biomarkers crucially involved in obesity (ghrelin, insulin resistance, and leptin/adiponectin ratio) and eating styles in children and adolescents with obesity. Seventy participants aged between 8 and 16 (56.2% men) fulfilled the Spanish version of the Dutch Eating Behavior Questionnaire for Children to measure external, emotional, and restrained eating styles. In addition, concentrations of ghrelin, leptin, adiponectin, insulin, and glucose were obtained through a blood test. Hierarchical multiple regression analyses controlling for age and sex were computed for each eating style. Results indicated that individuals with higher ghrelin concentration levels showed lower scores in restrained eating (β = −0.61, p < 0.001). The total model explained 32% of the variance of the restrained pattern. No other relationships between obesity-related biomarkers and eating behaviors were found. This study highlights that one of the obesity-risk factors, namely lower plasma ghrelin levels, is substantially involved in a well-known maladaptive eating style, restraint eating, in childhood obesity. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
14 pages, 550 KiB  
Article
Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study
by Isabel Baenas, Mikel Etxandi, Lucero Munguía, Roser Granero, Gemma Mestre-Bach, Isabel Sánchez, Emilio Ortega, Alba Andreu, Violeta L. Moize, Jose-Manuel Fernández-Real, Francisco J. Tinahones, Carlos Diéguez, Gema Frühbeck, Daniel Le Grange, Kate Tchanturia, Andreas Karwautz, Michael Zeiler, Hartmut Imgart, Annika Zanko, Angela Favaro, Laurence Claes, Ia Shekriladze, Eduardo Serrano-Troncoso, Raquel Cecilia-Costa, Teresa Rangil, Maria Eulalia Loran-Meler, José Soriano-Pacheco, Mar Carceller-Sindreu, Rosa Navarrete, Meritxell Lozano, Raquel Linares, Carlota Gudiol, Jordi Carratala, Maria T. Plana, Montserrat Graell, David González-Parra, José A. Gómez-del Barrio, Ana R. Sepúlveda, Jéssica Sánchez-González, Paulo P. P. Machado, Anders Håkansson, Ferenc Túry, Bea Pászthy, Daniel Stein, Hana Papezová, Jana Gricova, Brigita Bax, Mikhail F. Borisenkov, Sergey V. Popov, Denis G. Gubin, Ivan M. Petrov, Dilara Isakova, Svetlana V. Mustafina, Youl-Ri Kim, Michiko Nakazato, Nathalie Godart, Robert van Voren, Tetiana Ilnytska, Jue Chen, Katie Rowlands, Ulrich Voderholzer, Alessio M. Monteleone, Janet Treasure, Susana Jiménez-Murcia and Fernando Fernández-Arandaadd Show full author list remove Hide full author list
Nutrients 2022, 14(1), 100; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14010100 - 27 Dec 2021
Cited by 18 | Viewed by 8138
Abstract
Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and [...] Read more.
Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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14 pages, 2762 KiB  
Article
Transdiagnostic Perspective of Impulsivity and Compulsivity in Obesity: From Cognitive Profile to Self-Reported Dimensions in Clinical Samples with and without Diabetes
by Giulia Testa, Bernat Mora-Maltas, Lucía Camacho-Barcia, Roser Granero, Ignacio Lucas, Zaida Agüera, Susana Jiménez-Murcia, Rosa Baños, Valerie Bertaina-Anglade, Cristina Botella, Mònica Bulló, Felipe F. Casanueva, Søren Dalsgaard, José-Manuel Fernández-Real, Barbara Franke, Gema Frühbeck, Montserrat Fitó, Carlos Gómez-Martínez, Xavier Pintó, Geert Poelmans, Francisco J. Tinahones, Rafael de la Torre, Jordi Salas-Salvadó, Lluis Serra-Majem, Stephanie Vos, Theresa Wimberley and Fernando Fernández-Arandaadd Show full author list remove Hide full author list
Nutrients 2021, 13(12), 4426; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124426 - 10 Dec 2021
Cited by 7 | Viewed by 3367
Abstract
Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted [...] Read more.
Impulsive and compulsive behaviors have both been observed in individuals with obesity. The co-occurrence of obesity and type 2 diabetes (T2D) is more strongly associated with impulsivity, although there are no conclusive results yet. A multidimensional assessment of impulsivity and compulsivity was conducted in individuals with obesity in the absence or presence of T2D, compared with healthy, normal-weight individuals, with highly impulsive patients (gambling disorders), and with highly compulsive patients (anorexia nervosa). Decision making and novelty seeking were used to measure impulsivity, and cognitive flexibility and harm avoidance were used for compulsivity. For impulsivity, patients with obesity and T2D showed poorer decision-making ability compared with healthy individuals. For compulsivity, individuals with only obesity presented less cognitive flexibility and high harm avoidance; these dimensions were not associated with obesity with T2D. This study contributes to the knowledge of the mechanisms associated with diabetes and its association with impulsive–compulsive behaviors, confirming the hypothesis that patients with obesity and T2D would be characterized by higher levels of impulsivity. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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14 pages, 343 KiB  
Article
Nutrient Intake and Dietary Inflammatory Potential in Current and Recovered Anorexia Nervosa
by Olivia Patsalos, Bethan Dalton, Christia Kyprianou, Joseph Firth, Nitin Shivappa, James R. Hébert, Ulrike Schmidt and Hubertus Himmerich
Nutrients 2021, 13(12), 4400; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124400 - 09 Dec 2021
Cited by 5 | Viewed by 3192
Abstract
Anorexia nervosa (AN) is characterised by disrupted and restrictive eating patterns. Recent investigations and meta-analyses have found altered concentrations of inflammatory markers in people with current AN. We aimed to assess nutrient intake in participants with current or recovered AN, as compared to [...] Read more.
Anorexia nervosa (AN) is characterised by disrupted and restrictive eating patterns. Recent investigations and meta-analyses have found altered concentrations of inflammatory markers in people with current AN. We aimed to assess nutrient intake in participants with current or recovered AN, as compared to healthy individuals, and explore group differences in dietary inflammatory potential as a possible explanation for the observed alterations in inflammatory markers. We recruited participants with current AN (n = 51), those recovered from AN (n = 23), and healthy controls (n = 49). We used the Food Frequency Questionnaire (FFQ), to calculate a Dietary Inflammatory Index (DII®) score and collected blood samples to measure serum concentrations of inflammatory markers. In current AN participants, we found lower intake of cholesterol, compared to HCs, and lower consumption of zinc and protein, compared to HC and recovered AN participants. A one-way ANOVA revealed no significant group differences in DII score. Multivariable regression analyses showed that DII scores were significantly associated with tumour necrosis factor (TNF)-α concentrations in our current AN sample. Our findings on nutrient intake are partially consistent with previous research. The lack of group differences in DII score, perhaps suggests that diet is not a key contributor to altered inflammatory marker concentrations in current and recovered AN. Future research would benefit from including larger samples and using multiple 24-h dietary recalls to assess dietary intake. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
16 pages, 912 KiB  
Article
Psychopathological Symptoms and Well-Being in Overweight and Underweight Adolescents: A Network Analysis
by Michael Zeiler, Julia Philipp, Stefanie Truttmann, Karin Waldherr, Gudrun Wagner and Andreas Karwautz
Nutrients 2021, 13(11), 4096; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13114096 - 16 Nov 2021
Cited by 10 | Viewed by 3394
Abstract
Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on [...] Read more.
Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on data of 344 overweight adolescents (>90th BMI-percentile) and 423 underweight adolescents (<10th BMI-percentile) drawn from a large community sample (10–19 years) including behavioral and emotional problems (Youth Self-Report), eating disorder risk (SCOFF) and well-being variables (KIDSCREEN). Additionally, psychopathology and well-being scores of overweight and underweight individuals were compared with 1.560 normal weight adolescents. Compared to their normal weight peers, overweight adolescents showed elevated psychopathology and eating disorder risk as well as reduced well-being. Underweight adolescents reported increased levels of internalizing problems but no increased eating disorder risk or reduced well-being. The network analysis revealed that anxious/depressed mood and attention problems were the most central and interconnected nodes for both overweight and underweight subsamples. Among underweight individuals, social problems and socially withdrawn behavior additionally functioned as a bridge between other nodes in the network. The results support psychological interventions focusing on improving mood, coping with negative emotions and tackling inner tension. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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11 pages, 708 KiB  
Article
Sex-Specific Mediation Effects of Workplace Bullying on Associations between Employees’ Weight Status and Psychological Health Impairments
by Hans-Christian Puls, Ricarda Schmidt, Markus Zenger, Hanna Kampling, Johannes Kruse, Elmar Brähler and Anja Hilbert
Nutrients 2021, 13(11), 3867; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13113867 - 29 Oct 2021
Cited by 1 | Viewed by 17388
Abstract
Background: Individuals with obesity face weight-related discrimination in many life domains, including workplace bullying, especially in female employees with obesity. However, associations between experiences of workplace bullying and psychological health impairments considering weight status and sex remain unclear. Methods: Within a representative population-based [...] Read more.
Background: Individuals with obesity face weight-related discrimination in many life domains, including workplace bullying, especially in female employees with obesity. However, associations between experiences of workplace bullying and psychological health impairments considering weight status and sex remain unclear. Methods: Within a representative population-based sample of N = 1290 employees, self-reported experiences of workplace bullying were examined for variations by weight status and sex. Using path analyses, sex-specific mediation effects of workplace bullying on associations between weight status and work-related psychological health impairments (burnout symptoms, quality of life) were tested. Results: Employees with obesity experienced more workplace bullying than those with normal weight. Workplace bullying was positively associated with psychological health impairments and partially mediated the associations between higher weight status and elevated burnout symptoms and lower quality of life in women, but not in men. Conclusions: The result that more experiences of workplace bullying were, compared with weight status, more strongly associated with work-related psychological health impairments in women, but not in men, uniquely extends evidence on sex-specific effects within weight-related discrimination. Continued efforts by researchers, employers, and policy makers are needed to reduce weight-related discrimination in work settings, eventually increasing employees’ health and job productivity. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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16 pages, 1479 KiB  
Article
Conservative Treatment for Childhood and Adolescent Obesity: Real World Follow-Up Profiling and Clinical Evolution in 1300 Patients
by Gabriel Á. Martos-Moreno, Julián Martínez-Villanueva Fernández, Alicia Frías-Herrero, Álvaro Martín-Rivada and Jesús Argente
Nutrients 2021, 13(11), 3847; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13113847 - 28 Oct 2021
Cited by 3 | Viewed by 1918
Abstract
Background: Limited therapeutic tools and an overwhelming clinical demand are the major limiting factors in pediatric obesity management. The optimal protocol, environment, body mass index (BMI) change targets and duration of obesity-oriented interventions remain to be elucidated. Aims: We aimed to characterize the [...] Read more.
Background: Limited therapeutic tools and an overwhelming clinical demand are the major limiting factors in pediatric obesity management. The optimal protocol, environment, body mass index (BMI) change targets and duration of obesity-oriented interventions remain to be elucidated. Aims: We aimed to characterize the singularities of follow-up, anthropometric and metabolic evolution of a large cohort of pediatric patients with obesity in a specialized university hospital outpatient obesity unit. Patients and methods: Follow-up duration (up to seven years), attrition rate and anthropometric and metabolic evolution of 1300 children and adolescents with obesity were studied. An individualized analysis was conducted in patients attaining a high level of weight loss (over 1.5 BMI-SDS (standard deviation score) and/or 10% of initial weight; n = 252; 19.4%) as well as in “metabolically healthy” patients (n = 505; 38.8%). Results: Attrition rate was high during the early stages (11.2% prior to and 32.5% right after their initial metabolic evaluation). Mean follow-up time was 1.59 ± 1.60 years (7% of patients fulfilled 7 years). The highest BMI reduction occurred in the first year (−1.11 ± 0.89 SDS, p < 0.001 in 72.5% of patients). At the end of the follow-up, improvements in glucose and lipid metabolism parameters were observed (both p < 0.05), that were highest in patients with the greatest weight reduction (all p < 0.01), independent of the time spent to achieve weight loss. The pubertal growth spurt negatively correlated with obesity severity (r = −0.38; p < 0.01) but patients attaining adult height exceeded their predicted adult height (n = 308, +1.6 ± 5.4 cm; p < 0.001). “Metabolically healthy” patients, but with insulin resistance, had higher blood pressure, glucose, uric acid and triglyceride levels than those without insulin resistance (all p < 0.05). Preservation of the “metabolically healthy” status was associated with BMI improvement. Conclusions: Behavioral management of children with obesity can be effective and does not impair growth but is highly conditioned by high attrition. The best results regarding BMI reduction and metabolic improvement are achieved in the first year of intervention and can be preserved if follow-up is retained. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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17 pages, 1278 KiB  
Article
Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder
by Laura Marie Sommer, Georg Halbeisen, Yesim Erim and Georgios Paslakis
Nutrients 2021, 13(11), 3813; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13113813 - 26 Oct 2021
Cited by 4 | Viewed by 2317
Abstract
(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without [...] Read more.
(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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14 pages, 1963 KiB  
Article
Are Sensitivity to Punishment, Sensitivity to Reward and Effortful Control Transdiagnostic Mechanisms Underlying the Eating Disorder/Obesity Spectrum?
by Laurence Claes, Glenn Kiekens, Els Boekaerts, Lies Depestele, Eva Dierckx, Sylvia Gijbels, Katrien Schoevaerts and Koen Luyckx
Nutrients 2021, 13(10), 3327; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103327 - 23 Sep 2021
Cited by 2 | Viewed by 2025
Abstract
Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interindividual differences in sensitivity to punishment, sensitivity to [...] Read more.
Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interindividual differences in sensitivity to punishment, sensitivity to reward, and effortful control along the ED/obesity spectrum in women. We used data on 286 patients with eating disorders (44.6% AN-R, 24.12% AN-BP, and 31.82% BN), 126 healthy controls, and 640 Class II/III obese bariatric patients (32.81% Class II and 67.19% Class III) with and without binge eating. Participants completed the behavioral inhibition and behavioral activation scales, as well as the effortful control scale, to assess sensitivity to punishment and reward and effortful control. Results showed that patients with EDs scored significantly higher on punishment sensitivity (anxiety) compared to healthy controls and Class II/III obese patients; the different groups did not differ significantly on reward sensitivity. Patients with binge eating or compensatory behaviors scored significantly lower on effortful control than patients without binge eating. Differences in temperamental profiles along the ED/obesity spectrum appear continuous and gradual rather than categorical. This implies that it may be meaningful to include emotion regulation and impulse regulation training in the treatment of both EDs and obesity. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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12 pages, 1163 KiB  
Article
Neuropsychological Learning Deficits as Predictors of Treatment Outcome in Patients with Eating Disorders
by Ignacio Lucas, Romina Miranda-Olivos, Giulia Testa, Roser Granero, Isabel Sánchez, Jessica Sánchez-González, Susana Jiménez-Murcia and Fernando Fernández-Aranda
Nutrients 2021, 13(7), 2145; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13072145 - 23 Jun 2021
Cited by 9 | Viewed by 2749
Abstract
Eating disorders (EDs) are severe psychiatric illnesses that require individualized treatments. Decision-making deficits have been associated with EDs. Decision-making learning deficits denote a lack of strategies to elaborate better decisions that can have an impact on recovery and response to treatment. This study [...] Read more.
Eating disorders (EDs) are severe psychiatric illnesses that require individualized treatments. Decision-making deficits have been associated with EDs. Decision-making learning deficits denote a lack of strategies to elaborate better decisions that can have an impact on recovery and response to treatment. This study used the Iowa Gambling Task (IGT) to investigate learning differences related to treatment outcome in EDs, comparing between patients with a good and bad treatment outcome and healthy controls. Likewise, the predictive role of impaired learning performance on therapy outcome was explored. Four hundred twenty-four participants (233 ED patients and 191 healthy controls) participated in this study. Decision making was assessed using the Iowa Gambling Task before any psychological treatment. All patients received psychological therapy, and treatment outcome was evaluated at discharge. Patients with bad outcome did not show progression in the decision-making task as opposed to those with good outcome and the healthy control sample. Additionally, learning performance in the decision-making task was predictive of their future outcome. The severity of learning deficits in decision making may serve as a predictor of the treatment. These results may provide a starting point of how decision-making learning deficits are operating as dispositional and motivational factors on responsiveness to treatment in EDs. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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15 pages, 1267 KiB  
Article
Lifetime Weight Course as a Phenotypic Marker of Severity and Therapeutic Response in Patients with Eating Disorders
by Zaida Agüera, Cristina Vintró-Alcaraz, Isabel Baenas, Roser Granero, Isabel Sánchez, Jéssica Sánchez-González, José M. Menchón, Susana Jiménez-Murcia, Janet Treasure and Fernando Fernández-Aranda
Nutrients 2021, 13(6), 2034; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13062034 - 13 Jun 2021
Cited by 6 | Viewed by 2970
Abstract
The association between lifetime weight fluctuations and clinical characteristics has been widely studied in populations with eating disorders (ED). However, there is a lack of literature examining the potential role of weight course as a transdiagnostic factor in ED so far. Therefore, the [...] Read more.
The association between lifetime weight fluctuations and clinical characteristics has been widely studied in populations with eating disorders (ED). However, there is a lack of literature examining the potential role of weight course as a transdiagnostic factor in ED so far. Therefore, the aim of this study is to compare ED severity and treatment outcomes among four specific BMI profiles based on BMI-trajectories across the lifespan: (a) persistent obesity (OB-OB; (n = 74)), (b) obesity in the past but currently in a normal weight range (OB-NW; n = 156), (c) normal weight throughout the lifespan (NW-NW; n = 756), and (d) current obesity but previously at normal weight (NW-OB; n = 314). Lifetime obesity is associated with greater general psychopathology and personality traits such as low persistence and self-directedness, and high reward dependence. Additionally, greater extreme weight changes (NW-OB and OB-NW) were associated with higher psychopathology but not with greater ED severity. Higher dropout rates were found in the OB-OB group. These results shed new light on the BMI trajectory as a transdiagnostic feature playing a pivotal role in the severity and treatment outcome in patients with ED. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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Review

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16 pages, 968 KiB  
Review
Impact of Obesity in Kidney Diseases
by Vasilios Kotsis, Fernando Martinez, Christina Trakatelli and Josep Redon
Nutrients 2021, 13(12), 4482; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124482 - 15 Dec 2021
Cited by 24 | Viewed by 4337
Abstract
The clinical consequences of obesity on the kidneys, with or without metabolic abnormalities, involve both renal function and structures. The mechanisms linking obesity and renal damage are well understood, including several effector mechanisms with interconnected pathways. Higher prevalence of urinary albumin excretion, sub-nephrotic [...] Read more.
The clinical consequences of obesity on the kidneys, with or without metabolic abnormalities, involve both renal function and structures. The mechanisms linking obesity and renal damage are well understood, including several effector mechanisms with interconnected pathways. Higher prevalence of urinary albumin excretion, sub-nephrotic syndrome, nephrolithiasis, increased risk of developing CKD, and progression to ESKD have been identified as being associated with obesity and having a relevant clinical impact. Moreover, renal replacement therapy and kidney transplantation are also influenced by obesity. Losing weight is key in limiting the impact that obesity produces on the kidneys by reducing albuminuria/proteinuria, declining rate of eGFR deterioration, delaying the development of CKD and ESKD, and improving the outcome of a renal transplant. Weight reduction may also contribute to appropriate control of cardiometabolic risk factors such as hypertension, metabolic syndrome, diabetes, and dyslipidemia which may be protective not only in renal damage but also cardiovascular disease. Lifestyle changes, some drugs, and bariatric surgery have demonstrated the benefits. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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12 pages, 295 KiB  
Review
Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link
by Stella Stabouli, Serap Erdine, Lagle Suurorg, Augustina Jankauskienė and Empar Lurbe
Nutrients 2021, 13(12), 4321; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124321 - 29 Nov 2021
Cited by 36 | Viewed by 11150
Abstract
Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using [...] Read more.
Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanisms overlying the interaction including environmental and individual ones, and different are the approaches to reduce the consequences. Evidence-based treatments for obesity and eating disorders in childhood include as first line approaches weight loss with nutritional management and lifestyle modification via behavioral psychotherapy, as well as treatment of psychiatric comorbidities if those are not a consequence of the eating disorder. Drugs and bariatric surgery need to be used in extreme cases. Future research is necessary for early detection of risk factors for prevention, more precise elucidation of the mechanisms that underpin these problems and, finally, in the cases requiring therapeutic intervention, to provide tailored and timely treatment. Collective efforts between the fields are crucial for reducing the factors of health disparity and improving public health. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
20 pages, 959 KiB  
Review
Unveiling Metabolic Phenotype Alterations in Anorexia Nervosa through Metabolomics
by Laura Mayo-Martínez, Francisco J. Rupérez, Gabriel Á. Martos-Moreno, Montserrat Graell, Coral Barbas, Jesús Argente and Antonia García
Nutrients 2021, 13(12), 4249; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13124249 - 26 Nov 2021
Cited by 2 | Viewed by 5801
Abstract
Anorexia nervosa (AN) is a mental disorder characterized by an intense fear of weight gain that affects mainly young women. It courses with a negative body image leading to altered eating behaviors that have devastating physical, metabolic, and psychological consequences for the patients. [...] Read more.
Anorexia nervosa (AN) is a mental disorder characterized by an intense fear of weight gain that affects mainly young women. It courses with a negative body image leading to altered eating behaviors that have devastating physical, metabolic, and psychological consequences for the patients. Although its origin is postulated to be multifactorial, the etiology of AN remains unknown, and this increases the likelihood of chronification and relapsing. Thus, expanding the available knowledge on the pathophysiology of AN is of enormous interest. Metabolomics is proposed as a powerful tool for the elucidation of disease mechanisms and to provide new insights into the diagnosis, treatment, and prognosis of AN. A review of the literature related to studies of AN patients by employing metabolomic strategies to characterize the main alterations associated with the metabolic phenotype of AN during the last 10 years is described. The most common metabolic alterations are derived from chronic starvation, including amino acid, lipid, and carbohydrate disturbances. Nonetheless, recent findings have shifted the attention to gut-microbiota metabolites as possible factors contributing to AN development, progression, and maintenance. We have identified the areas of ongoing research in AN and propose further perspectives to improve our knowledge and understanding of this disease. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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20 pages, 953 KiB  
Review
Obesity and Cardiometabolic Risk Factors: From Childhood to Adulthood
by Dorota Drozdz, Julio Alvarez-Pitti, Małgorzata Wójcik, Claudio Borghi, Rosita Gabbianelli, Artur Mazur, Vesna Herceg-Čavrak, Beatriz Gonzalez Lopez-Valcarcel, Michał Brzeziński, Empar Lurbe and Elke Wühl
Nutrients 2021, 13(11), 4176; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13114176 - 22 Nov 2021
Cited by 128 | Viewed by 16691
Abstract
Obesity has become a major epidemic in the 21st century. It increases the risk of dyslipidemia, hypertension, and type 2 diabetes, which are known cardiometabolic risk factors and components of the metabolic syndrome. Although overt cardiovascular (CV) diseases such as stroke or myocardial [...] Read more.
Obesity has become a major epidemic in the 21st century. It increases the risk of dyslipidemia, hypertension, and type 2 diabetes, which are known cardiometabolic risk factors and components of the metabolic syndrome. Although overt cardiovascular (CV) diseases such as stroke or myocardial infarction are the domain of adulthood, it is evident that the CV continuum begins very early in life. Recognition of risk factors and early stages of CV damage, at a time when these processes are still reversible, and the development of prevention strategies are major pillars in reducing CV morbidity and mortality in the general population. In this review, we will discuss the role of well-known but also novel risk factors linking obesity and increased CV risk from prenatal age to adulthood, including the role of perinatal factors, diet, nutrigenomics, and nutri-epigenetics, hyperuricemia, dyslipidemia, hypertension, and cardiorespiratory fitness. The importance of ‘tracking’ of these risk factors on adult CV health is highlighted and the economic impact of childhood obesity as well as preventive strategies are discussed. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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21 pages, 659 KiB  
Review
Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review
by Johanna Louise Keeler, Janet Treasure, Mario F. Juruena, Carol Kan and Hubertus Himmerich
Nutrients 2021, 13(11), 4158; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13114158 - 20 Nov 2021
Cited by 19 | Viewed by 8368
Abstract
Anorexia nervosa (AN) is a highly complex disorder to treat, especially in severe and enduring cases. Whilst the precise aetiology of the disorder is uncertain, malnutrition and weight loss can contribute to reductions in grey and white matter of the brain, impairments in [...] Read more.
Anorexia nervosa (AN) is a highly complex disorder to treat, especially in severe and enduring cases. Whilst the precise aetiology of the disorder is uncertain, malnutrition and weight loss can contribute to reductions in grey and white matter of the brain, impairments in neuroplasticity and neurogenesis and difficulties with cognitive flexibility, memory and learning. Depression is highly comorbid in AN and may be a barrier to recovery. However, traditional antidepressants are often ineffective in alleviating depressive symptoms in underweight patients with AN. There is an urgent need for new treatment approaches for AN. This review gives a conceptual overview for the treatment of AN with ketamine. Ketamine has rapid antidepressant effects, which are hypothesised to occur via increases in glutamate, with sequelae including increased neuroplasticity, neurogenesis and synaptogenesis. This article provides an overview of the use of ketamine for common psychiatric comorbidities of AN and discusses particular safety concerns and side effects. Potential avenues for future research and specific methodological considerations are explored. Overall, there appears to be ample theoretical background, via several potential mechanisms, that warrant the exploration of ketamine as a treatment for adults with AN. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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3 pages, 216 KiB  
Reply
Reply to Skokou, M. Comment on “Keeler et al. Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review. Nutrients 2021, 13, 4158”
by Johanna Louise Keeler, Janet Treasure, Mario F. Juruena, Carol Kan and Hubertus Himmerich
Nutrients 2022, 14(10), 2119; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14102119 - 19 May 2022
Cited by 2 | Viewed by 1618
Abstract
In response to our narrative review, which suggested the use of the glutamatergic n-methyl-D-aspartate (NMDA) receptor antagonist ketamine as a potential treatment for anorexia nervosa (AN) [...] Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
2 pages, 202 KiB  
Comment
Comment on Keeler et al. Ketamine as a Treatment for Anorexia Nervosa: A Narrative Review. Nutrients 2021, 13, 4158
by Maria Skokou
Nutrients 2022, 14(10), 2118; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14102118 - 19 May 2022
Cited by 1 | Viewed by 1674
Abstract
Anorexia Nervosa (AN) represents a difficult therapeutic challenge, with up to 4% prevalence among females and increasing incidence among youth [...] Full article
(This article belongs to the Special Issue Eating Disorders and Obesity: Through the Life Course)
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