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The association between body mass index (BMI) and binge-eating disorder (BED) is well-established. However, data on the extent to which BMI is associated with progression from binge-eating behavior into BED among adolescents are limited, which was the aim of this investigation. Participants were 9964 U.S. adolescents from the Adolescent Brain Cognitive Development (ABCD) Study, aged 9-13 at the time of study enrollment. A computerized parent-reported assessment was used to establish adolescents' binge-eating behaviors and BED. Cox proportional hazards models adjusting for sociodemographic covariates were used to examine prospective associations between BMI and likelihood of BED onset among a) adolescents with binge-eating behavior, and b) adolescents with no binge-eating behavior. Of 975 adolescents who met the study criteria for binge-eating behavior, 89 (9.1%) subsequently met the study criteria for BED. Of 8989 adolescents with no binge-eating behavior, 82 (0.9%) subsequently met the study criteria for BED. BMI percentile was significantly associated with the likelihood of BED onset in participants with (adjusted HR = 1.03, 95% confidence interval [CI] 1.00, 1.06) and participants without (adjusted HR = 1.05, 95% CI 1.03, 1.07) binge-eating behavior. Results were also significant when examining BMI as a dichotomous predictor (above and below 85th percentile) among those with (adjusted HR = 2.60, 95% CI 1.00, 6.68) and those without (adjusted HR = 6.01, 95% CI 3.90, 11.10) binge-eating behavior. Overall, results indicate that elevated BMI is prospectively associated with a greater risk for BED onset among U.S. adolescents with or without binge-eating behavior. Adolescents with a higher BMI may benefit from screening for binge eating, and prevention/early intervention strategies to mitigate the risk for developing BED., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cannabis use is prevalent among individuals with binge eating (BE; i.e., the inability to control eating behavior). Yet, only two studies to date (both over 20 years old) have tested if cannabis use relates to clinical severity among BE samples. Characterizing the relationship between cannabis use, eating disorder (ED) severity, and other psychiatric symptoms in BE samples is necessary for informing screening and clinical recommendations. The present study characterized cannabis use among adults with BE and tested between-group and within-group relationships between cannabis use and eating disorder symptoms, alcohol consumption and symptoms, and depression symptoms. Participants ( N = 165) were treatment-seeking adults with at least once weekly BE in the past 3 months who completed clinical interviews and self-report measures before treatment. Over 23% of participants reported cannabis use in the past 3 months, with most persons using cannabis reported using "once or twice" or "monthly." Most persons using cannabis reported cannabis-related symptoms. Persons using cannabis reported significantly greater alcohol consumption and were more likely to report alcohol-related symptoms compared to persons not using cannabis. No associations were observed between cannabis use, eating disorder symptoms, and depressions symptoms. These findings indicate that a notable subset of patients with BE use cannabis and experience cannabis-related problems, and that cannabis and alcohol use may be related for these individuals. Considering legal and sociocultural shifts in cannabis availability and prevalence, results from the present study support screening for cannabis and alcohol use patterns in patients with BE. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Problematic alcohol use and binge eating frequently co-occur. High levels of negative affect, negative urgency, and/or shame may increase the likelihood that problematic alcohol use and binge eating co-occur over time., Objective: Examine 1) the temporal relationship between problematic alcohol use and binge eating among college women, who are at high risk for both, and 2) the additive and moderating effects of shared, emotion-based risk factors in models involving both problematic alcohol use and binge eating., Method: In n = 302 college women assessed at two time points across 8 months, we used hierarchical linear regression to invstigate our objectives., Results: Baseline problematic alcohol use and baseline shame independently predicted increases in follow-up binge eating, controlling for baseline binge eating. In addition, the interaction between problematic alcohol use and shame accounted for further variance in subsequent binge eating (the influence of baseline problematic alcohol use on follow-up binge eating was stronger at higher levels of baseline shame). The reciprocal relationship was not significant: baseline binge eating did not predict follow-up problematic alcohol use independently or in conjunction with risk factors. Neither negative affect nor negative urgency showed predictive effects beyond prior behavior and shame. Results support 1) problematic alcohol use as a prospective risk factor for binge eating, 2) shame as an additive predictor of binge eating, and 3) shame as a positive moderator of binge eating prediction from problem drinking., Conclusion: Addressing shame and problematic alcohol use may be warranted in binge eating interventions for college women., Competing Interests: Declaration of competing interest All authors have no conflicts of interest to report., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Bulimia, which means a person has episodes of eating a very large amount of food (bingeing) during which the person feels a loss of control over their eating, is the most primitive reason for being overweight and obese. The extended literature has indicated that childhood emotional abuse has a close relationship with adverse mood states, bulimia, and obesity. To comprehensively understand the potential links among these factors, we evaluated a multiple mediation model in which anxiety/depression and bulimia were mediators between childhood emotional abuse and body mass index (BMI). A set of self-report questionnaires, including the Childhood Trauma Questionnaire (CTQ), Beck Anxiety Inventory, Beck Depression Inventory (BDI), and Eating Disorder Inventory (EDI), was sent out. Clinical data from 37 obese patients (age: 29.65 ± 5.35, body mass index (BMI): 37.59 ± 6.34) and 37 demographically well-matched healthy people with normal body weight (age: 31.35 ± 10.84, BMI: 22.16 ± 3.69) were included in the investigation. We first performed an independent t-test to compare all scales or subscale scores between the two groups. Then, we conducted Pearson correlation analysis to test every two variables' pairwise correlation. Finally, multiple mediation analysis was performed with BMI as the outcome variable, and childhood emotional abuse as the predictive variable. Pairs of anxiety, bulimia, and depression, bulimia were selected as the mediating variables in different multiple mediation models separately. The results show that the obese group reported higher childhood emotional abuse (t = 2.157, p = 0.034), worse mood state (anxiety: t = 5.466, p < 0.001; depression: t = 2.220, p = 0.030), and higher bulimia (t = 3.400, p = 0.001) than the healthy control group. Positive correlations were found in every pairwise combination of BMI, childhood emotional abuse, anxiety, and bulimia. Multiple mediation analyses indicate that childhood emotional abuse is positively linked to BMI (β = 1.312, 95% CI = 0.482-2.141). The model using anxiety and bulimia as the multiple mediating variables is attested to play roles in the relationship between childhood emotional abuse and obesity (indirect effect = 0.739, 95% CI = 0.261-1.608, 56.33% of the total effect). These findings confirm that childhood emotional abuse contributes to adulthood obesity through the multiple mediating effects of anxiety and bulimia. The present study adds another potential model to facilitate our understanding of the eating psychopathology of obesity., (© 2024. The Author(s).)

Labelling specific psychiatric concerns as 'niche' topics relegated to specialty journals obstructs high-quality research and clinical care for these issues. Despite their severity, eating disorders are under-represented in high-impact journals, underfunded, and under-addressed in psychiatric training. We provide recommendations to stimulate broad knowledge dissemination for under-acknowledged, yet severe, psychiatric disorders.

Background: Eating disorders are seen mainly as a problem affecting women, not just by the public at large, but also in specialized circles. Although it is true that more women than men suffer from all types of eating disorder, pertinent reviews have clearly shown that they do indeed occur in men, and that the available evidence on the matter is limited. The stigmatization of men with eating disorders makes it harder for these men, and for the relevant professionals, to recognize the symptoms and to seek or provide help., Methods: This review is based on publications retrieved by a selective search in PubMed on the epidemiological, diagnostic, clinical, and therapeutic aspects of eating disorders in men., Results: Current estimated lifetime prevalences in men are 0.2% for anorexia nervosa, 0.6% for bulimia nervosa, and 1% for bingeeating disorder; the corresponding figures for women are 1.4%, 1.9%, and 2.8%. Men and women may display different manifestations. Women are thought to be mainly seeking a slim figure and weight reduction; men, a muscular build. The established Germanlanguage screening and diagnostic tools, however, do not cover the types of symptoms that are more common in men. Little is known about whether treatment yields comparable results in men and women., Conclusion: It is important to combat the stigmati - zation of men with eating disorders and to remove the obstacles to their appropriate diagnosis and treatment. The current methods of screening and diagnosis need to be adapted to take account of the special aspects of abnormal eating behavior in men. It remains unclear whether and how the disorderspecific treatment of these conditions in men should differ from their treatment in women.

This study examined the relationship between weight stigma and disordered eating behaviors in university students during the COVID-19 pandemic, considering individuals with and without overweight. A national sample of 738 college students completed an online questionnaire at three time points between July 2020 and December 2021, reporting their experiences of weight stigma, perceived increase in weight stigma during the pandemic, internalized weight stigma, and disordered eating behaviors. The findings showed that the trajectories of disordered eating behaviors varied depending on participants' anthropometric status. Among those with overweight, there was a decrease over time in binge eating, food restriction, and purging. Conversely, the non-overweight group experienced a slight increase in binge eating from T2 to T3. Using the Generalized Estimating Equations model, the study revealed that weight stigma predicted disordered eating behaviors in both weight spectrums during the pandemic. Experiences of weight stigma and the perceived increase in weight stigma significantly increased the likelihood of engaging in binge eating, food restriction, and purging among individuals with overweight. Furthermore, the internalization of weight stigma was longitudinally associated with all examined eating behaviors, regardless of anthropometric status. These findings highlight the importance of addressing weight stigma to prevent disordered eating in college students., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to declare., (Copyright © 2023. Published by Elsevier Ltd.)

Eating disorders and excessive attachment to social media are a matter of great concern among youths. This study assessed the prevalence of eating disorders and their association with social media addiction among youths. A descriptive cross-sectional study was conducted on 350 participants aged 14-25 years. Two pre-validated tools were used, i.e., the Eating Attitude Test and the Social Networking Addiction Scale. SPSS was used to analyze the data. Out of the 350 students, 42% had probable eating disorders, and 41.7% had social media addictions. The findings revealed that the chances of having eating disorders were significantly higher among youths who lived in separate places, smoked, and had a family history of eating disorders ( p ≤ 0.05). Furthermore, the dieting domain displayed notably higher scores for youths living separately ( p ≤ 0.05) and smokers ( p ≤ 0.01). Moreover, the scores for bulimia and food preoccupation were significantly higher among participants who were married ( p = 0.038), were smokers ( p = 0.027), and had a family history of eating disorders ( p = 0.001). Higher scores in the oral control domain were reported by females ( p ≤ 0.05) and severely obese youths ( p ≤ 0.01). Moreover, social media addiction was significantly higher among students aged 18-21 ( p ≤ 0.01). Spearman's correlation revealed that social media addiction has a weak positive relationship with eating disorders ( r = 0.133, p ≤ 0.01), particularly bulimia and food preoccupation ( r = 0.173, p ≤ 0.001). This reflects the need to address the harmful consequences of social media addiction that might raise the likelihood of developing eating disorders, particularly bulimia nervosa.

Objectives: The purpose of this study is to investigate whether the relationship between weight stigma experiences and disordered eating behaviors during the COVID-19 pandemic is mediated by weight gain concern and psychological distress among university students with and without overweight., Methods: A cross-sectional study was conducted with university students from five regions of Brazil who participated in the baseline assessment of the Online Cohort on Eating Behavior and Health (July/August 2020). Information on the frequency of binge eating episodes, food restriction, and purging, as well as experienced weight stigma, weight gain concern, and psychological distress, were recorded in an online questionnaire. Stratified structural equation modeling (SEM) analyses were performed to address the research questions of interest., Results: Out of the total sample (n = 2511), 33.5% of participants reported experiencing weight stigma. The prevalence of binge eating episodes, food restriction, and purging was 43.7%, 24.1%, and 5.4%, respectively. These behaviors were more prevalent in individuals with overweight than in those without this condition. Furthermore, it was observed that weight gain concern and psychological distress mediated the relationship between weight stigma and disordered eating behaviors regardless of body weight status., Conclusions: Experiences of weight stigma and disordered eating behaviors were prevalent among Brazilian university students, especially among those with overweight. Weight gain concern and psychological distress appear to be important factors underlying the relationship between these constructs during the pandemic, and they can contribute to the development of targeted strategies for the prevention and management of disordered eating., Level of Evidence: Level V, cross-sectional study., (© 2023. The Author(s).)

Recent studies have found increasing rates of overweight and obesity in bulimia nervosa (BN). However, the relationships between body mass index (BMI) and BN symptoms and other clinically relevant constructs are unknown. Participants ( N = 152 adults with BN) were assigned to three groups by BMI: group with no overweight or obesity (NOW-BN; BMI <25; N = 32), group with overweight (OW-BN; BMI ≥25 and <30; N = 66), and group with obesity (O-BN; BMI ≥30; N = 54). We compared the groups on demographics, diet and weight histories, body esteem, BN symptoms, and depression using chi square, analysis of variance, analysis of covariance, and Poisson regression models. The O-BN group was older ( d = 0.57) and OW-BN and O-BN groups had greater proportions of race/ethnic minorities than NOW-BN group. The O-BN group was significantly younger at first diet ( d = 0.41) and demonstrated significantly higher cognitive dietary restraint ( d = 0.31). Compared to NOW-BN, O-BN participants had lower incidence of objective binge eating (incidence rate ratio [IRR] = 4.86) and driven exercise (IRR = 7.13), and greater incidence of vomiting (IRR = 9.30), laxative misuse (IRR = 4.01), and diuretic misuse ( d = 2.08). O-BN participants also experienced higher shape ( d = 0.41) and weight ( d = 0.42) concerns than NOW-BN and OW-BN, although NOW-BN experienced higher shape ( d = 0.44) and weight ( d = 0.39) concerns than OW-BN. Groups did not differ on depression scores. These results were replicated when examining BMI as a continuous predictor across the full sample, with the exception of objective binge eating and driven exercise, which were not significantly associated with BMI. Individuals with BN and comorbid obesity have distinct clinical characteristics. Existing interventions may need to be adapted to meet clinical needs of these individuals.

Background: We studied the effect of the Covid-19 pandemic on child eating disorder hospitalizations in Quebec, Canada. Quebec had one of the strictest lockdown measures targeting young people in North America., Methods: We analyzed eating disorder hospitalizations in children aged 10-19 years before and during the pandemic. We used interrupted time series regression to assess trends in the monthly number of hospitalizations for anorexia nervosa, bulimia nervosa, and other eating disorders before the pandemic (April 2006 to February 2020), and during the first (March to August 2020) and second waves (September 2020 to March 2021). We determined the types of eating disorders requiring hospital treatment and identified the age, sex and socioeconomic subgroups that were most affected., Results: Hospitalization rates for eating disorders increased during the first (6.5 per 10,000) and second waves (12.8 per 10,000) compared with the period before the pandemic (5.8 per 10,000). The increase occurred for anorexia nervosa as well as other types of eating disorders. The number of girls and boys aged 10-14 years admitted for eating disorders increased during wave 1. Wave 2 triggered an increase in eating disorder admissions among girls aged 15-19 years. Hospitalization rates increased earlier for advantaged than disadvantaged youth., Conclusions: The Covid-19 pandemic affected hospitalizations for anorexia nervosa as well as other eating disorders, beginning with girls aged 10-14 years during wave 1, followed by girls aged 15-19 years during wave 2. Boys aged 10-14 years were also affected, as well as both advantaged and disadvantaged youth., (© 2023 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

Evidence suggests social media use is strongly linked to disordered eating (e.g., binge eating and dietary restraint) among adolescent and young adult women, in part because it promotes engagement in social comparison (the tendency to evaluate one's own standing or ability by comparing it to another's). Yet no study has examined the impact of social media use and comparison on disordered eating among middle-aged women. Participants (N = 347), ages 40-63, completed an online survey about their social media use, social comparison, and disordered eating (bulimic symptoms, dietary restraint, and broad eating pathology). Results indicated that 89 % (n = 310) of middle-aged women used social media in the past year. Most participants (n = 260; 75 %) used Facebook, and at least a quarter used Instagram or Pinterest. Approximately 65 % (n = 225) used social media at least daily. Controlling for age and body mass index, social media-specific social comparison was positively associated with bulimic symptoms, dietary restriction, and broad eating pathology (all ps < 0.001). Multiple regression models evaluating frequency of social media use and social media-specific social comparison together revealed that social comparison explained a significant amount of unique variance in bulimic symptoms, dietary restriction, and broad eating pathology (all ps < 0.001) above and beyond frequency of social media use. Instagram explained a significant proportion of variance of dietary restraint compared to other social media platforms (p = .001). Findings suggest a large percentage of middle-aged women frequently engage with some type of social media. Further, social media-specific social comparison, rather than frequency of social media use, may be driving disordered eating in this age group of women., Competing Interests: Declaration of competing interest None., (Copyright © 2023. Published by Elsevier Ltd.)

Background: Disordered eating behaviors (DEB) impact on health and wellbeing worldwide. This study aimed to examine sociodemographic trends in the prevalence of DEB over 20 years in the Australian general population., Methods: Data were derived from five sequential cross-sectional surveys (1998, 2008, 2009, 2016 and 2017) with population-representative samples of adults and adolescents residing in South Australia ( N = 15 075). DEBs investigated were objective binge eating (OBE), strict dieting/fasting, and purging. Sociodemographic data included gender, age, educational level, work and marital status, and residence., Results: OBE prevalence increased significantly. Strict dieting/fasting also increased from 1998 to 2008/9 but remained stable between 2008/9 and 2016/7. Purging prevalence did not change significantly over time. All survey years were associated with a significantly higher odds of OBE, and strict diet/fasting compared to 1998. Lower age, a higher Accessibility Remoteness Index of Australia (ARIA) score, higher body mass index (BMI), higher educational attainment, and not being in a married or de facto relationship were independently associated with greater adjusted odds for endorsing OBE. Younger age, female gender, and higher BMI were also independently associated with greater adjusted odds for endorsing strict dieting/fasting., Conclusions: The increased prevalence of DEBs in various strata of Australian society has both public health and clinical implications. The results refute the stereotype that eating disorders (EDs) predominantly affect young women. They build impetus for future research on EDs among men and older individuals, with a view to developing tailored public health and clinical interventions for these populations.

Purpose: Perceiving one's weight as "overweight" is associated with disordered eating in adolescence. Yet, it is unknown whether weight perceptions change during adolescence, or whether these weight perception transitions predict disordered eating. This study aims to: (1) characterize weight perception transitions from early to late adolescence among a population-based sample and (2) examine whether weight perception transitions in adolescence predict concurrent and future disordered eating into young adulthood., Methods: Eating and Activity in Teens and Young Adults (N = 1,414) survey data were used to examine correlates of weight perception transitions from early (M age  = 14.9 ± 1.6 years) to late adolescence (M age  = 19.4 ± 1.6 years). Adjusted generalized estimating equations were used to determine whether weight perception transitions in adolescence predicted concurrent and future disordered eating in emerging adulthood (M age  = 25.2 ± 1.6 years) and young adulthood (M age  = 31.0 ± 1.6 years)., Results: Weight perceptions were stable from early to late adolescence for 77.2% of adolescents, whereas 15.5% transitioned to perceiving their weight as "overweight" and 7.3% stopped perceiving "overweight" in late adolescence. Perceived "overweight", especially in late adolescence, was associated with higher concurrent and long-term disordered eating up to 10 years later. For example, the predicted prevalence of binge eating in young adulthood among individuals who perceived their weight as "overweight" throughout adolescence was 20.1% compared to 6.6% for those who never perceived their weight as "overweight" in adolescence., Discussion: Adolescent weight perception was relatively stable in this population-based sample. However, weight perception transitions that involved perceiving "overweight", particularly in late adolescence, were associated with long-term higher risk of disordered eating., (Copyright © 2023 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to assess the association between anorexia nervosa (AN), bulimia nervosa (BN), attention deficit/hyperactivity disorder (ADHD), and associated impairments (e.g., suicidality)., Methods: A secondary data analysis of the American College Health Association-National College Health Assessment IIc (Fall 2015-Spring 2019) was conducted to assess the prevalence of comorbid anorexia or bulimia + ADHD, symptoms, and impairments among college student (N = 342,432; M age  = 20.39, SD = 1.88). Logistic regressions were used to compare eating disorder symptomology, treatment utilisation, and suicidality among college students., Results: Compared to college students without ADHD, college students with ADHD were 18.30× more likely to be diagnosed with anorexia or bulimia and reported greater use of weight loss techniques (p's < 0.001). College students with comorbid anorexia or bulimia + ADHD reported higher rates of dieting to lose weight (aOR = 1.27, 95% CI: 1.12, 1.43, p < 0.001) and treatment utilisation (aOR = 1.30, 95% CI: 1.06, 1.50, p < 0.001) compared to college students with AN or BN only. The highest level of suicidality was reported in college students with the comorbid AN or BN + ADHD., Conclusion: Elevated eating disorder symptoms and comorbidity is found among college students with ADHD. Increased screening and prevention for anorexia and bulimia is needed among young adults with ADHD to enhance care for those with these eating disorders., (© 2022 Eating Disorders Association and John Wiley & Sons Ltd.)

(1) Background: Obesity and eating disorders (ED) can coexist resulting in worse health outcomes. Youth with ED are more likely to have obesity relative to peers with a healthy weight. Pediatric providers deliver first-line care to children and youth of all sizes and body shapes from infancy to adolescents. As healthcare providers (HCPs), we bring biases into our practice. Learning to recognize and address these biases is needed to provide the best care for youth with obesity. (2) Purpose: This paper aims to summarize the literature regarding the prevalence of ED beyond binge eating in youth with obesity and discuss how the intersection of weight, gender, and racial biases impact the assessment, diagnosis, and treatment of ED. We provide recommendations for practice and considerations for research and policy. (3) Conclusions: The assessment and treatment of ED and disordered eating behaviors (DEBs) in youth with obesity is complex and requires a holistic approach. This approach begins with identifying and understanding how one's implicit biases impact care. Providing care from a patient-centers lens, which considers how the intersection of multiple stigmatized identities increases the risk for DEBs in youth with obesity may improve long-term health outcomes.

The prevalence of binge eating spectrum conditions (BESC) are increasing globally. However, there is a lack of data from general population samples in low- and middle-income countries. Thus, this study described the food consumption during objective binge eating episodes (OBE) in people with BESC from a metropolitan city in Brazil. Participants comprised 136 adults (18 years old-60 years old) with Binge Eating Disorder (BED), Bulimia Nervosa (BN), or recurrent binge eating (RBE) from a two-phase epidemiological survey. They were interviewed in their homes by trained lay interviewers using the Questionnaire on Eating and Weight Patterns updated for the DSM-5 to assess BESC diagnosis and food consumption during a typical OBE. Overall, participants consumed a mean of 1067 kcal during the episodes. For the most part, these calories were derived from carbohydrates (58%) and lipids (30%), irrespective of the diagnosis. Regarding food item consumption, individuals with BED and RBE consumed staple foods (mainly rice and beans) more frequently than those with BN. Conversely, participants with BN ingested sugar-sweetened beverages more frequently than the BED group. In conclusion, there were differences in the eating patterns of individuals with BESC in Brazil. BED and RBE participants consumed more typical foods, whereas those with BN preferred foods with a high content of energy during their OBE.

Background: Sleep problems are known to compound the negative effects of other health issues, such as eating disorders and the associated behavior of binge eating. Previous studies suggested associations between binge eating and sleep problems, but the strength of the relationship is unknown., Methods: We conducted a systematic review with meta-analyses examining the relationship between binge eating and sleep parameters. We searched for studies in Scopus, PubMed, and PsycInfo. The quality of evidence, including risk of bias, was assessed with adaptations of the Newcastle-Ottawa Scale and the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies, depending on study design. Data was synthesized as the difference in sleep between people who did or did not have binge eating., Results: Thirty-one reports of studies met our eligibility criteria. Results are presented in 12 meta-analyses. In the 7 reports of studies (with 4448 participants) that assessed poor overall sleep quality, we found poorer overall sleep quality in people with binge eating compared to people without binge eating, with a standardized mean difference of 0.77 (95% confidence interval [CI] 0.61-0.92; P < 0.001), which is a large effect size. In addition, we found evidence that people with binge eating had significantly greater hypersomnia/daytime sleepiness (7 reports of studies with 4370 participants), insomnia (5 reports of studies with 12,733 participants), and difficulty falling asleep (3 reports of studies with 4089 participants) compared to people without binge eating, with moderate effect sizes (standardized mean differences of 0.57-0.66)., Conclusions: People with binge eating exhibit poorer overall sleep quality compared to people without binge eating, and may also exhibit greater hypersomnia/daytime sleepiness, insomnia, and difficulty falling asleep. It is recommended that healthcare professionals routinely screen for poor overall sleep quality when treating people with binge eating-and address sleep difficulties when present., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Binge-eating (BE) symptoms are relatively common in major depressive disorder (MDD), but their prognostic role is not fully understood. This study compared two groups of patients with MDD experiencing or not BE symptoms to ascertain differences in terms of clinical manifestations, presence of bipolar features, and antidepressant treatment outcomes. The study involved 482 outpatients collected within the Combining Medications to Enhance Depression Outcomes (CO-MED) trial, who were assessed with scales for depressive and hypomanic symptomatology, suicidality, comorbid mental disorders, and childhood traumas. BE symptoms were reported in 95 patients (20%). Patients with MDD experiencing BE symptoms were characterized by higher scores of negative self-outlook ( P = 0.0018), negative outlook of future ( P = 0.0014), irritability ( P = 0.0043), comorbid anxiety disorders (generalized anxiety disorder: P = 0.0006; panic disorder: P &lt; 0.0001; social phobia: P &lt; 0.0001), obsessive-compulsive disorder ( P = 0.0053), hypomanic symptoms (increased talkativeness: P = 0.0029; reduced need for sleep: P = 0.0171), and suicidality (suicidal propensity: P = 0.0013; suicidal risk: P = 0.0148; lifetime suicidal behavior: P = 0.0052). BE symptoms (OR = 2.02; 95% CI = 1.06-3.84) and depression severity (OR = 1.04; 95% CI = 1.00-1.08) were independently associated with lifetime attempted suicide. The presence of BE symptoms might indicate higher severity of depressive disorder. Suicidal risk is a major issue in these patients, whereas the association between BE and bipolar features needs further research., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: Disordered eating behaviors (DEBs) have long-term, deleterious effects on health and are more prevalent among socially marginalized groups, likely as a result of systemic inequities across social determinants of health (SDoH). This exploratory study aimed to identify subgroups of emerging adults characterized by main and interactive associations between SDoH and two forms of DEB (binge eating, extreme unhealthy weight control behaviors)., Method: Participants (n = 1568; age 22.2 ± 2.1 years) from the United States were drawn from the EAT 2010-2018 longitudinal study. Conditional inference tree (CIT) analyses derived main and intersecting SDoH related to DEB across 33 input variables collected during adolescence and emerging adulthood., Results: The binge eating CIT revealed five subgroups (prevalence: 6.3-23.2%) shaped by variables collected during emerging adulthood: appearance-based teasing (p < .001), financial difficulty (p = .003), gender (p < .001), and everyday discrimination (p = .008). The CIT results for extreme unhealthy weight control behaviors derived six subgroups (prevalence: 2.3-45.5%) shaped by weight teasing (p < .001) and gender (p < .001) during emerging adulthood and public assistance (p = .008) and neighborhood safety (p = .007) in adolescence., Discussion: This exploratory study revealed distinct subgroups of emerging adults with varying DEB prevalence, suggesting that variability in DEB prevalence may be partially explained by intersecting SDoH during adolescence and emerging adulthood. Hypothesis-driven research and replication studies are needed to further explore the associations between SDoH and DEB during emerging adulthood., Public Significance Statement: Disordered eating behaviors are common among young people in the United States and have long-term health consequences. This exploratory study identified subgroups of young people, characterized by combinations of social inequities (e.g., financial difficulties, teasing). Results highlight high-risk subgroups of emerging adults that should be examined further in hypothesis-driven research., (© 2022 The Authors. International Journal of Eating Disorders published by Wiley Periodicals LLC.)

Longitudinal data are needed to examine effects of the COVID-19 pandemic on disordered eating. We capitalized on an ongoing, longitudinal study collecting daily data to examine changes in disordered eating symptoms in women across 49 days that spanned the time before and during the COVID-19 outbreak in the United States. Women from the Michigan State University Twin Registry ( N = 402) completed daily questionnaires assessing a range of symptoms (e.g., binge eating, weight/shape concerns, liking/wanting of palatable food (PF) and whole foods, hunger). Dates of the first US COVID-19 case, first case in each participant's state, and onset of the initial stay-at-home orders (SHOs) were used to categorize women into those who completed all daily assessments prior to, during, or after these dates. We used mixed linear models and specification-curve analysis to examine between-person (i.e., differences between women assessed before vs during/after COVID-19) and within-person (i.e., changes in symptoms from days before to days after the dates) effects of the pandemic. Results showed significantly higher levels of binge-related pathology (e.g., odds of binge eating, liking/wanting of PF) in women who completed assessments during/after COVID-19 events, and significantly increased liking/wanting of PF in the days following the pandemic onset. By contrast, minimal between- or within-person differences were observed for other variables, including weight/shape concerns, compensatory behaviors, hunger, or liking/wanting whole foods. Overall, results suggest a specific effect of the pandemic on binge-related phenotypes in women. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the past 10 years, written in English, Spanish or Portu-guese found in The Cochrane Library Plus, PubMed, WOS, PsycINFO, and Scopus databases and with enough methodological quality. Nine studies were included in this review with a sample of 2,069 adolescents; 75.3% were female, mean age was 18 years, and mostly used Facebook and Instagram. Despite some positive aspects, SNs promote beauty standards in terms of thinness, allow comparisons between peers increasing concerns about weight, and create spaces that encourage anorexia and bulimia. Therefore, SN use plays a role in the development of eating disorders. The promotion of extreme thinness in girls makes this population more vulnerable.

Purpose: Binge eating disorder (BED), bulimia nervosa (BN) and recurrent binge eating (RBE) are binge eating spectrum conditions causing a significant impact in individual's health and functioning. Information regarding those conditions came mostly from high-income countries. The objective of this study was to assess the prevalence of DSM-5 BED, BN and RBE and correlates in a representative sample from a metropolitan area of a middle-income country., Methods: The data were obtained from a cross-sectional population-based household survey in two stages in Rio de Janeiro, Brazil. Noninstitutionalized residents aged 18-60 years were assessed by lay interviewers using the Questionnaire of Eating and Weight Patterns-5 (QEWP-5). Positive cases and a paired sample screen-negative cases were reassessed by phone with the Eating Disorders Section of SCID-I-P (adapted for DSM-5). The data were collected from September 2019 to February 2020., Results: Overall, 2297 individuals were interviewed. Prevalence of BED was 1.4%, BN 0.7%, RBE 6.2%. Psychiatric comorbidities, such as depression, anxiety and ADHD were significantly more prevalent in people with BED, BN and RBE than in people without these eating problems. Several medical conditions, when controlling for body mass index, were significantly more prevalent in people with BED, BN and RBE. People with BED and BN had marked impairments in work/school, social and family life, reduced mental and physical HRQoL and under half had sought treatment., Conclusion: As in high income countries, in Rio de Janeiro, Brazil, BED, BN and RBE are prevalent conditions and are associated with elevated BMI, functional impairment, psychiatric and medical comorbidity and poorer HRQoL., (© 2022. The Author(s).)

Purpose: To examine cross-sectional associations between food insecurity and 12-month eating disorders, mood disorders, and anxiety disorders among U.S. adults., Methods: This study used data collected between 2001 and 2003 from 2914 participants in the National Comorbidity Survey-Replication, a nationally representative sample of U.S. adults (mean age = 44.9 years; 53.4% female). Twelve-month food insecurity was assessed with a modified version of the Short Form U.S. Household Food Security Scale. Twelve-month DSM-IV diagnoses of mental disorders were based on the World Health Organization Composite International Diagnostic Interview. Modified Poisson regression models were conducted, adjusting for age, sex, race/ethnicity, education, and income-to-poverty ratio., Results: Food insecurity was experienced by 11.1% of participants. Food insecurity was associated with greater prevalence of bulimic-spectrum eating disorders (prevalence ratio [PR] = 3.81; 95% confidence interval [CI] 2.26-6.42), mood disorders (PR = 2.53; 95% CI 1.96-3.29), and anxiety disorders (PR = 1.69; 95% CI 1.39-2.07)., Conclusion: Results indicate that food insecurity is associated with a range of internalizing mental disorders, though these findings should be confirmed with contemporary data to reflect DSM-5 diagnostic updates and the economic effects of the COVID-19 pandemic. Findings from this study emphasize the need to expand food insecurity interventions and improve access to mental health services for food-insecure populations., (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.)

Existing research on perfectionism and binge eating suggests that socially prescribed, self-oriented, and other-oriented perfectionism (Socially Prescribed Perfectionism, SPP; Self-Oriented Perfectionism, SOP; and Other-Oriented Perfectionism, OOP) are differentially related to binge eating. However, previous studies have largely utilized cross-sectional methodology. The present study used a 20-day daily diary methodology to examine associations between daily levels of perfectionistic dimensions and next-day binge eating behaviors with a nonclinical sample of emerging adults ( N = 263). Zero-inflated negative binomial regression models indicated that daily SPP (but not SOP or OOP) predicted a greater intensity of next-day binge eating behaviors in the count portion of the model; however, daily levels of perfectionistic dimensions did not predict the presence/absence of next-day binge eating behaviors in the zero-inflated portion of the model. Additionally, analyses examining the reverse causal direction (i.e., binge eating behaviors predicting higher next-day perfectionism) failed to provide evidence that the occurrence or intensity of binge eating behaviors predicts next-day levels of SPP, SOP, or OOP. Overall, at a daily level, SPP appears to be a vulnerability factor for binge eating behaviors. It may be helpful for clinicians to target state-levels of SPP to reduce harmful binge eating behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Introduction: Pressure to meet U.S. military weight requirements during service may predispose some service members to develop psychiatric disorders such as eating disorders or unhealthy eating behaviors, which may persist after military discharge. Specifically, research examining U.S. military veterans has found that in weight management programs, veterans with binge-eating behaviors have shown poor treatment outcomes. Overall, previous research suggests that veterans experience considerable and persistent disordered eating problems, and in addition may experience a higher prevalence of disordered eating in comparison to the general U.S. population. Research on Post-9/11 Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans is needed as this group frequently presents with high rates of medical and psychiatric disorders. The current study used clinician-administered structured interviews to examine relationships between psychiatric, health, and demographic variables in a sample of Post-9/11 OEF/OIF/OND veterans with binge-eating or overeating behavior or neither., Materials and Methods: This article presents secondary analyses of the baseline phase from data obtained for the Survey of the Experiences of Returning Veterans. Using structured phone interviews, we cross-sectionally examined patterns of medical comorbidities between sociodemographic, health, eating, and psychiatric variables in 846 recently deployed U.S. veterans with binge-eating behaviors (reporting both overeating and loss of control [LOC] eating), overeating behaviors (overeating without LOC), or healthy controls (absence of any disordered eating). Study procedures were approved by the Department of Veterans Affairs (VA) Institutional Review Boards, and informed consent was obtained from the participants. A series of chi-square and analysis of variance tests revealed significant bivariate between-group differences in sociodemographic, health, eating, and psychiatric variables. Variables with significant group differences (P < .05) were entered into a multinomial logistic regression to examine relationships between psychiatric, health, and eating factors and binge-eating severity., Results: Results of the multinomial logistic regression analysis showed that women relative to men were less likely to overeat. When comparing the binge-eating group and controls, higher body mass index was associated with higher odds of binge eating. Furthermore, for the overeating group in comparison to controls, fasting behavior was associated with higher odds of overeating. For the psychiatric variables, the binge-eating and overeating groups were associated with higher rates of compulsive buying when compared to healthy controls. Additionally, the overeating group was associated with higher rates of alcohol dependence. Lastly, binge-eating and overeating behaviors were positively associated with specific psychiatric and health comorbidities., Conclusions: Further research is needed to inform the development of effective treatments for disordered eating problems, as evidenced by an anticipated increase of veterans entering the VA healthcare system and the high rate of binge eating observed in our study and prior research in Post-9/11 veterans. Moreover, our study findings suggest the relevance of screening veterans for compulsive buying. This study was limited by its relatively small sample which only examined disordered eating behaviors. Future studies could simultaneously explore binge-eating behaviors and binge-eating disorder diagnoses in larger samples. Study strengths include a diverse sample of Post-9/11 veterans with sizable female representation., (© The Association of Military Surgeons of the United States 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: The association of bulimic symptoms with sensation seeking is uncertain; however, both behaviors have been linked to alcohol problems. We assessed in a longitudinal, community-based setting whether sensation seeking in adolescence is associated with bulimic symptoms in early adulthood, also accounting for alcohol problems., Methods: Finnish men (N = 2000) and women (N = 2467) born between 1974-1979 completed Zuckerman's sensation seeking scale (SSS) at age 18. Alcohol problems (Malmö-modified Michigan alcoholism screening test (Mm-MAST) and bulimic symptoms [eating disorder inventory-2, bulimia subscale (EDI-Bulimia), population and clinical scoring systems] were defined at age 22-27. We examined relationships between SSS, Mm-MAST, and EDI-Bulimia using Pearson's correlation coefficient (r) and linear regression., Results: Alcohol problems were moderately correlated with sensation seeking and bulimic symptoms (population scoring) among women and men (r = 0.21-0.31). The correlation between sensation seeking and bulimic symptoms (population scoring) was weak among men (r = 0.06, p = 0.006) and even weaker and non-significant among women (r = 0.03, p = 0.214). Adjustment for alcohol problems removed the association between sensation seeking and bulimic symptoms among men. Furthermore, there were no significant correlations between sensation seeking and bulimic symptoms when assessing EDI-Bulimia clinical scoring., Conclusion: Sensation seeking and bulimic symptoms were not associated among women. The association between sensation seeking and bulimic symptoms among men was entirely attributable to increased alcohol problems among those with higher sensation seeking. While this association may be important on the population level, its clinical significance may be minor., Level of Evidence: Level III, well-designed cohort study., (© 2021. The Author(s).)

Various types of stressors are associated with maladaptive eating, but how the stressor of everyday discrimination (e.g., less respect, poorer service) relates to maladaptive eating and adaptive eating remains unclear. We examined everyday discrimination as a predictor of maladaptive and adaptive eating. Data were collected in a population-based study, Eating and Activity over Time (N = 1410, ages 18-30). Everyday discrimination was categorized as none, low, moderate, or high. Outcomes included maladaptive eating (i.e., overeating and binge eating) and adaptive eating (i.e., intuitive eating and mindful eating). Modified Poisson regressions estimated the prevalence ratios (PRs) for overeating and binge eating associated with everyday discrimination. Linear regressions estimated associations between everyday discrimination and intuitive and mindful eating scores. After adjustment for age, ethnicity/race, gender, and socioeconomic status, moderate and high levels of discriminatory experiences were each associated with a significantly greater prevalence of binge eating (PR = 2.2, [95% CI = 1.3-3.7] and PR = 3.1, [95% CI = 2.0-4.7], respectively) and lower intuitive (β = -0.4, [95% CI = -0.7, -0.2] and β = -0.5 [95% CI = -0.8, -0.3], respectively), and mindful eating scores (β = -0.3, [95% CI = -0.6, -0.1] and β = -0.5 [95% CI = -0.8, -0.3], respectively) compared to young adults with no discriminatory experience. Public health efforts to prevent maladaptive eating and encourage the adoption of adaptive eating should consider the potential contribution of everyday discrimination and the need to advocate for equity and inclusion., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: There is a lack of data concerning the prevalence of eating disorders in patients requesting aesthetic surgery in spite of a large body of literature on the psychopathology of these patients. This may mostly be due to insufficient diagnostic assessment instruments. Therefore, the aim of this study was to determine the prevalence of eating disorders and their comorbidities in patients undergoing aesthetic surgery., Methods: The assessment of prevalence of the eating disorders as anorexia nervosa, bulimia nervosa and binge eating disorder as well as other mental disorders was performed with the Structured Clinical Interview for DSM-IV mental disorders (SCID), axis 1., Results: 212 patients (198 females, 14 males), requesting different types of aesthetic surgery, were included in this study. Eating disorders had a current prevalence of 8.0% (17/212) and a lifetime prevalence of 11.3% (24/212). Anorexia nervosa was predominantly found in patients with breast augmentation [current: 7.4% (2/27); lifetime: 11.1% (3/27)] and rhinoplasty [6.3 (1/16); 12.6% (2/16)]. Bulimia nervosa dominated in patients with liposuction [10% (3/30); 13.3% (4/30)] and binge eating disorder in patients with abdominoplasty [current/lifetime: 10.8% (4/37)]. Levels of significance (p ≤ 0.002) were reached for prevalence of the eating disorders in above mentioned types of surgery, when compared to prevalence data of the general population (two proportion Z test for SPSS)., Conclusion: Eating disorders are distributed according to a certain pattern in the different types of aesthetic surgery. Interestingly, the current prevalence of eating disorders (17/212) was comparable to that of body dysmorphic disorder (26/212)., (Copyright © 2021. Published by Elsevier Ltd.)

Adverse experiences, such as childhood abuse and other violence victimization, are associated with problematic eating. However, whether different types of adversity relate to both maladaptive and adaptive eating behaviors is unclear. This study examined the associations of different adverse experiences with maladaptive (i.e., overeating and binge eating) and adaptive (i.e., intuitive eating and mindful eating) eating by gender. Data were derived from the EAT-2018 (Eating and Activity over Time) study (N = 1411, aged 18-30 years in 2017-2018). Modified Poisson regressions were used to examine the associations between adverse experiences and the prevalence of maladaptive eating. Linear regressions were used to examine the associations between adverse experiences and adaptive eating scores. Each adverse experience was associated with greater prevalence of maladaptive eating and lower adaptive eating scores. Among women, intimate partner sexual violence was strongly associated with more overeating (PR = 2.1 [95% CI = 1.4-3.1]) and binge eating (PR = 2.4 [95% CI = 1.5-3.9]), and less mindful eating (β = -0.6, [95% CI = -0.8, -0.3]); being attacked, beaten, or mugged was most associated with less intuitive eating (β = -0.5, [95% CI = -0.8, -0.2]). Among men, being attacked, beaten, or mugged was strongly associated with more overeating (PR = 2.1 [95% CI = 1.2-3.5]) and binge eating (PR = 3.2 [95% CI = 1.6-6.5]); intimate partner physical violence was strongly associated with less intuitive eating (β = -0.6, [95% CI = -0.9, -0.2]); childhood emotional abuse was strongly associated with less mindful eating (β = -0.8, [95% CI = -1.0, -0.5]). To improve eating behaviors, adverse life experiences and the potential impact on maladaptive and adaptive eating should be considered., (Copyright © 2021. Published by Elsevier Ltd.)

Background: The nature and significance of impulse-control difficulties in binge-eating disorder (BED) are uncertain. Most emerging research has focused on food-specific rather than general impulsivity. The current study examines the clinical presentation of patients with BED categorized with and without clinical levels of general impulsivity., Method: A total of 343 consecutive treatment-seeking patients with BED were categorized as having BED with general impulsivity (GI+; N = 73) or BED without general impulsivity (GI-: N = 270) based on structured diagnostic and clinical interviews. The groups were compared on demographic, developmental, and psychological features, and on rates of psychiatric and personality comorbidity., Results: Individuals with BED and general impulsivity (GI+) reported greater severity of eating-disorder psychopathology, greater depressive symptoms, and greater rates of comorbidity than those without general impulsivity (GI-)., Conclusions: A subtype of individuals with BED and general impulsivity may signal a more severe presentation of BED characterized by heightened and broader psychopathology. Future work should investigate whether these impulse-control difficulties relate to treatment outcomes.

This study aimed to elucidate the shared and non-shared behavioral, sociocultural, and personal risk factors underlying binge eating and binge drinking among a sample ( n  = 1764) of participants from Project EAT at baseline and 10-year follow-up. Longitudinal and cross-sectional analyses revealed a range of risk factors associated with binge eating and binge drinking at 10 years, which varied by gender. The results revealed that risks associated with binge eating and binge drinking often differed, and thus full-scale dual preventive interventions for concurrent binge eating and binge drinking may be less effective. However, general prevention and intervention programs may emphasize shared risk factors.

Due to the spread of COVID 2019, the Italian government imposed a lockdown on the national territory. Initially, citizens were required to stay at home and not to mix with others outside of their household (Phase 1); eventually, some of these restrictions were lifted (Phase 2). To investigate the impact of lockdown on emotional and binge eating, an online survey was conducted to compare measures of self-reported physical (BMI), psychological (Alexithymia), affective (anxiety, stress, and depression) and social (income, workload) state during Phase 1 and Phase 2. Data from 365 Italian residents showed that increased emotional eating was predicted by higher depression, anxiety, quality of personal relationships, and quality of life, while the increase of bingeing was predicted by higher stress. Moreover, we showed that higher alexithymia scores were associated by increased emotional eating and higher BMI scores were associated with both increased emotional eating and binge eating. Finally, we found that from Phase 1 to Phase 2 binge and emotional eating decreased. These data provide evidence of the negative effects of isolation and lockdown on emotional wellbeing, and, relatedly, on eating behaviour., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

To limit the spread of the novel coronavirus (COVID-19), many countries have introduced mandated lockdown or social distancing measures. Although these measures may be successful against COVID-19 transmission, the pandemic and attendant restrictions are a source of chronic and severe stress and anxiety which may contribute to the emergence or worsening of symptoms of eating disorders and the development of negative body image. Therefore, in this study, we aimed to: (1) classify different conditions associated with COVID-19-related stress, COVID-19-related anxiety, and weight status; and (2) analyze and compare the severity of dimensions typically related to eating disorders symptomatology and body image in individuals with different COVID-19-related stress, COVID-19-related anxiety, and weight status. Polish women ( N = 671, M age = 32.50 ± 11.38) completed measures of COVID-19-related stress and anxiety along with body dissatisfaction, drive for thinness, and bulimia symptomatology subscales of the Eating Disorders Inventory, and the appearance evaluation, overweight preoccupation, and body areas satisfaction subscales of the Multidimensional Body-Self Relations Questionnaire. The following four clusters were identified through cluster analysis: (a) Cluster 1 ( N = 269), healthy body weight and low COVID-related stress ( M = 3.06) and anxiety ( M = 2.96); (b) Cluster 2 ( N = 154), healthy body weight and high COVID-related stress ( M = 5.43) and anxiety ( M = 5.29); (c) Cluster 3 ( N = 127), excess body weight and high COVID-related stress ( M = 5.23) and anxiety ( M = 5.35); (d) Cluster 4 ( N = 121), excess body weight and low COVID-related stress ( M = 2.69) and anxiety ( M = 2.83). Our results showed that Clusters 3 and 4 had significantly greater body dissatisfaction and lower appearance evaluation and body areas satisfaction than Clusters 1 and 2. Cluster 3 also had a significantly higher level of drive for thinness, bulimia, and overweight preoccupation than Clusters 1 and 2. These preliminary findings may mean that the COVID-19 pandemic and attendant anxiety and stress caused by the pandemic are exacerbating symptoms of eating disorders and negative body image, with women with excess weight particularly at risk.

Objective: To identify the relationship between binge eating and alcohol consumption., Methods: This is an integrative literature review of publications from 2015 to 2019, using the Pubmed, Cinhahl, Psynet, Lilacs, Embase and Web of Science virtual databases and the descriptors ("Binge-Eating" OR "Bulimia") AND Alcohol* in English, Spanish and Portuguese., Results: A total of 964 articles were found. After reading the titles and abstracts and excluding duplicates, 36 articles were included in the final sample (35 in English and one in Portuguese). They were grouped into three thematic categories: "sample profile and characterization", "genetic and environmental factors", and "emotions and behavior"., Conclusions: The data indicate the existence of a relationship between binge eating and alcohol use, and some factors were associated with this comorbidity. Still, there were few publications on the theme at the national level, indicating the need for developing more research. These findings may support therapeutic actions and strategies for identification of cases, embracing approaches and more effective treatments to meet the individual's biopsychosocial demands., Level of Evidence: Level V, narrative review.

Binge eating and binge drinking are two of the most common health-risk behaviors among young people showing to frequently co-occur in nonclinical samples of adolescent boys and girls. The present study examined the role of different dimensions of family functioning in binge behaviors among adolescents. One thousand and twenty young to late adolescents (507 girls and 517 boys) with ages ranging from 16 to 22 years participated in the study and completed a survey of self-report measures. Our findings showed that adolescents who binge eat and drink and adolescents who only binge eat perceived a lower quality of family functioning with lower levels of cohesion, flexibility, communication, satisfaction and higher degree of disengagement compared to adolescents who do not binge and adolescents who only binge drink. Only adolescents who engage in both binge behaviors reported higher levels of chaotic style compared to other binge groups. Furthermore, living in families poorly flexible, highly disengaged and with communication problems among members resulted as risk factors for binge eating behavior. Results suggest the importance for prevention programs to be based on an integrated approach focused on improving family environment such as the ability in changing family structure to deal effectively with developmental problems and defining clear home rules adolescents may stand on.

This study examined the relative influence of trait and state weight, shape, and eating concerns on dysregulated eating in the daily lives of sexual minority women with overweight and obesity. This study is a secondary analysis of data from an Ecological Momentary Assessment (EMA) study of 55 sexual minority women with overweight/obesity. Trait shape, weight, and eating concerns were assessed at baseline. For the following five days, participants used a smartphone to report state weight/shape concerns, overeating, and binge eating five times daily. Women who endorsed higher levels of trait weight, shape, and eating concerns at baseline reported more frequent state weight/shape concerns in daily life. Trait eating concerns were associated with higher odds of binge eating during EMA, but trait weight/shape concerns were unrelated to future dysregulated eating. In daily life, state weight/shape concerns was associated with greater risk for over/binge eating at the concurrent EMA prompt, the subsequent EMA prompt, and over the course of a full day, independent of trait concerns. State weight and shape concerns may play an important role in predicting dysregulated eating in daily life among sexual minority women of higher body weight., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: Binge drinking is an important health problem, and it has been related to binge eating and fat intake in animal models, but this relationship has not been tested in humans. The first objective of this study was to analyze whether binge eating and fat intake are related to binge drinking in a youth sample. The second objective was to analyze whether binge eating and fat intake mediate the relationship between individual factors associated with binge eating and fat intake (sex, body mass index (BMI), drive for thinness, body dissatisfaction, eating styles, impulsivity, and food addiction) and binge drinking., Methods: A sample of 428 undergraduate students filled out several questionnaires on binge drinking, binge eating, fat intake, drive for thinness, body dissatisfaction, eating styles, food addiction, and impulsivity., Results: Results showed an excellent model fit: χ 2 (25) = 30.342 ( p = 0.212), comparative fit index (CFI) = 0.992, root mean squared error of approximation (RMSEA) = 0.022 [90% CI = 0.000, 0.047]. Binge eating and fat intake were positively related to binge drinking. Furthermore, emotional eating, external eating, and food addiction showed positive and statistically significant indirect relationships with binge drinking, whereas the relationship with restrained eating was negative., Conclusions: These findings point to the need to use a broader approach in understanding and preventing binge drinking in the youth population by showing the influence of the eating pattern on this problem. This information could be helpful in preventing future behaviors and improving interventions that address health risk behaviors.

Introduction: The interplay between eating disorders and psychosis is a challenging field to which little attention has been paid. Its study raises conceptual and methodological questions in both areas, making the diagnosis and management of patients difficult. Such questions are addressed and illustrated with a review and case report., Methods: The authors present the case of a woman with Anorexia Nervosa and with comorbid Shared Psychotic Disorder, based on a literature review regarding the comorbidity between eating disorders and psychosis. The authors conducted a non-systematic review by searching the PubMed database, using the Mesh Terms "anorexia nervosa", "bulimia nervosa", "comorbidity" and "psychotic disorders"., Results: The findings suggest that studies on the subject are limited by issues regarding data on the prevalence of comorbidities, phenomenological aspects of eating disorders, and the interface and integration with psychotic symptoms., Conclusions: The case presented illustrates the difficulties in managing a patient with a comorbid eating disorder and psychosis. In order to ensure a rigorous assessment of both psychotic and eating disorder symptoms, the focus should be on the pattern of appearance or emergence of symptoms, their phenomenology, clinical and family background of the patient, and clinical status on follow-up.

Objective: Although clinical studies suggest that bulimia symptoms are common in youth, research on the prevalence of such symptoms and of their association with comorbid internalizing problems in the general population has been limited. This study aimed to evaluate the gender-specific prevalence of bulimia symptoms in Czech youth and explored the association between a clinical level of self-reported bulimia symptoms (CLBS) and internalizing problems by gender, controlling for age, socio-economic status and puberty status., Method: The study was conducted on a representative national sample of Czech youth (N = 4430, 57.0% female) using self-report scales. Multivariate analysis of covariance (MANCOVA) was used to examine the associations., Results: The 3-month CLBS prevalence was higher in girls (11.4%) than in boys (3.8%) and in both genders a CLBS was associated with higher levels of comorbid internalizing problems., Discussion: Timely recognition of bulimia symptoms and associated risk factors is important for early prevention and intervention strategies., Level of Evidence: V, cross-sectional descriptive study (according to Oxford (UK) CEBM Levels of Evidence, 2011).

The contribution of an addictive process to anorexia nervosa (AN) is an area of growing interest. Yet, little is known about how the food addiction concept (FA) may be of interest in understanding AN. This study investigates prevalence of FA diagnostic and its association with markers of severity in individuals with AN. We conducted a retrospective study in a sample of 73 patients with AN. We assessed FA with the Yale Food Addiction Scale 2.0, depressive and anxiety disorders, impulsivity (Beck Depression Inventory, STAI, BIS-11) and eating behavior (BITE, EDE-Q). Prevalence of FA in our sample was 47%. FA was significantly associated and positively correlated with the binge-eating/purging subtype of AN, higher levels of depression, anxiety and greater eating psychopathology. FA was not associated with level of impulsivity nor leptin and IGF-1 blood levels. The relationship between FA severity and AN severity was mediated by the severity of binge eating behaviors. Our results suggest that the presence of FA may represent a more severe variant of AN. Longitudinal studies are needed to better understand the etiologic process between FA and AN., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The objective of this study is to assess the effect of alcohol consumption, anxiety, and food restriction before and after consuming alcohol and body image on the risk of anorexia and bulimia in college students from Tijuana, Baja California, through predictive statistical models. A quantitative, descriptive, and cross-sectional design and a non-probabilistic sample of 526 college students from Tijuana, Baja California, México were used. Application of the scales (with acceptable psychometric properties) was conducted in classrooms. Through path analyses, four models were found with adequate indicators of goodness of fit: (1) risk of anorexia in women [Chi Square (X 2 ) = 5.34, p = 0.376, Adjusted Determination Coefficient (R 2 )= 0.250]; (2) anorexia risk for men (X 2 = 13.067, p = 0.192, R 2 = 0.058); (3) risk of bulimia in women (X 2 = 3.358, p = 0.645, R 2 = 0.202); and bulimia risk for men (X 2 = 14.256, p = 0.075, R 2 = 0.284). The findings provide empirical evidence for the food and alcohol disturbance model.

Purpose: Binge eating is a common behavior in children and adolescents who suffer from either eating disorders (EDs) or from severe obesity. The purpose of the current study was to explore the association between social anxiety and binge eating and compare prevalence rates of social anxiety between youth with severe obesity or EDs who did or did not engage in binge eating., Methods: Retrospective data on treatment-seeking youth's (n = 490) eating behaviors and social anxiety at assessment were analyzed., Results: Results indicate that those who engage in binge eating have higher rates of social anxiety; frequency of binges does not predict severity of social anxiety, though social anxiety predicts presence of binge eating. Adolescents with EDs had higher rates of social anxiety than those with obesity, and for both groups, rates of social anxiety were highest in those who binge., Conclusions: Clinicians who treat youth with EDs and with obesity should be aware of the relationship between binge eating and social anxiety and of the need for treatment to address both these disorders., Level of Evidence: Level V, cross-sectional descriptive study.

Aim: The study was aimed at studying binge eating behavior in urban adolescents. This was in keeping with the increasing prevalence of obesity and lifestyle disorders amongst Indian population especially in adolescent groups., Methods: 2000 adolescents English speaking schools in Mumbai were administered the Binge Eating Scale and the Eating Behaviors and Pattern Questionnaire after assent and parental consent. The prevalence of Binge eating behavior was estimated along with the socio-demographic data and other data from scale which was analyzed using the Chi square test and ANOVA where appropriate., Results: The mean age of the total sample was 15.05 ± 1.65 years. Females reported higher Binge eating behavior than males and majority of the sample belonging to upper and lower middle- class families reported high binge eating behavior. The prevalence of Binge eating behavior was high with 1002 (50.1 %) adolescents reporting moderate binge eating while 736 (36.8 %) reporting severe binge eating. Significantly greater adolescents in the binge eating group reported irregular menses and being overweight and obese. There was a significantly greater proportion of adolescents in the binge eating group that ate out weekly and ate more fried food., Conclusion: There is an increasing trend of obesity and lifestyle disorders in adolescent population that can be linked to Binge eating behavior however, the role of binge eating in context of one of the potential cause of lifestyle disorders and obesity has not been studied in Indian adolescents despite the prevalence of Binge eating and overweight being high in this population, we need further larger studies to corroborate the findings of this study., Competing Interests: Declaration of Competing Interest Nil., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Introduction: The transition from high school to college is a developmentally sensitive period that is high-risk for the escalation of alcohol use. Although risky drinking is a common problem among freshmen, engagement in treatment services is very low. College alcohol interventions target drinking directly at a time when students may be uninterested in changing their drinking. Approaches that indirectly target drinking may be particularly effective. Behavioral activation (BA) is an intervention that indirectly addresses mental health conditions by guiding individuals to engage in reinforcing activities that align with their values (Lejuez et al., 2001). A pilot study of a BA intervention administered in a semester-long freshman orientation course reported a significant decrease in drinking-related problems compared to students in standard orientation course (Reynolds et al., 2011)., Methods: The cluster-randomized trial will test the efficacy of BA administered in a semester-long (16 week) freshman orientation course, compared to a standard orientation course in 540 freshmen spread over 36 course sections (18 sections each). A 5-month post-treatment assessment will measure durability of effects., Discussion: The study will test a promising BA intervention that addresses factors limiting participation in other programs by targeting alcohol use indirectly and by integrating an intervention into college curriculum. This study represents a first step toward developing an intervention course that could be widely disseminated to address the persistent college drinking problem and its consequences., Clinical Trials Registration Number: NCT04038190., (Copyright © 2020 Elsevier Inc. All rights reserved.)

[Correction Notice: An Erratum for this article was reported in Vol 32(2) of Psychological Assessment (see record 2020-04120-001). In the article, there are two errors in the Method section for Study 2. First, in the "Body dissatisfaction" subsection, the range of total scores for the Body-Image Ideals Questionnaire was incorrectly listed as being "between 0 and 99." The correct range is from - 3 to 9. Second, in the "Dieting and bulimia" subsection, the reference for the Eating Attitudes Test (EAT-26) was incorrectly cited as "Garner et al., 1983." Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The Eating Attitudes Test: Psychometric features and clinical correlates. Psychological Medicine , 12, 871-878. http://dx.doi .org/10.1017/s0033291700049163.] Females are at risk for body image and eating disturbance when they internalize societally prescribed standards of Western beauty. With respect to messages to be thin or muscular, numerous scales are available that measure internalization. However, many women are now receiving messages about the desirability of being both thin and toned, yet no self-report measure of internalization of a fit female body ideal exists. Our aim was to develop a multidimensional tool (i.e., the Fit Ideal Internalization Test; FIIT) useful for assessing women's internalization of the fit ideal (i.e., a lean and toned body ideal). Three studies were conducted, recruiting independent groups of women attending university to complete surveys. In Study 1 ( N = 300, age 16-51), women completed the FIIT items, and a 3-factor structure of fit idealization (8 items), fit overvaluation (8 items), and fit behavioral drive (4 items) was established through exploratory factor analysis. Also, items loading highly on each of the factors had good interitem correlations. In Study 2 ( N = 354, age 16-63), women completed the 20-item FIIT and validation measures. The 3-factor structure of the FIIT was confirmed, and findings supported convergent, discriminant, and incremental validity of the FIIT subscale scores (and a total score). In Study 3 ( N = 67, age 17-50), the 2-week test-retest reliability of the FIIT scores was high. Overall, the 3 FIIT subscales are related but also distinct domains of fit ideal internalization that conform to theory and may be used as individual subscales or potentially as a composite score. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Purpose: "Making weight" behaviors are unhealthy weight control strategies intended to reduce weight in an effort to meet weight requirements. This study aimed to examine a brief measure of making weight and to investigate the relationship between making weight and weight, binge eating, and eating pathology later in life., Methods: Participants were veterans [N = 120, mean age 61.7, mean body mass index (BMI) 38.0, 89.2% male, 74.2% Caucasian] who were overweight/obese and seeking weight management treatment. Participants completed the making weight inventory (MWI), a measure of making weight behaviors engaged in during military service, and validated measures of eating behavior. Analyses compared participants who engaged in at least one making weight behavior (MWI+) versus those who did not (MWI-)., Results: The MWI had good internal consistency. One-third of participants were MWI+ and two-thirds were MWI-. The most frequently reported behavior was excessive exercise, reported in one-quarter of the sample, followed by fasting/skipping meals, sauna/rubber suit, laxatives, diuretics, and vomiting. MWI+ participants were significantly more likely to be in a younger cohort of veterans, to be an ethnic/racial minority, and to engage in current maladaptive eating behaviors, including binge eating, vomiting, emotional eating, food addiction, and night eating, compared to the MWI- group. Groups did not differ on BMI., Conclusions: One-third of veterans who were overweight/obese screened positive for engaging in making weight behaviors during military service. Findings provide evidence that efforts to "make weight" are related to binge eating and eating pathology later in life. Future research and clinical efforts should address how to best eliminate unhealthy weight control strategies in military service while also supporting healthy weight management efforts.

Objective: To investigate whether obese patients with binge eating (BE) have higher alexithymic features; to explore the different relationships between psychological features (alexithymia, depression, and anxiety) and BE., Method: Three hundred sixty one obese BE-patients were evaluated for alexithymia, psychological distress, and BE. Alexithymia was measured with the 20-item Toronto Alexithymia Scale (TAS-20); BE was assessed with the BE Scale (BES), and depression and anxiety symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS)., Results: Patients with BE reported significantly higher TAS-20 total scores than those without BE (p < .001). The SEM analysis showed that the difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF) components of alexithymia affected BE along different pathways. DIF was found as a major factor influencing altered eating both directly (p = .20*) and above all through the mediation of psychological distress (p = .19***), whereas DDF affected BE only through psychological distress at a lesser extent (p = .09**)., Discussion: Alexithymic difficulties in affective awareness may play an important role in the onset and maintenance of BE, especially when patients experienced anxiety and depression symptoms. Clinicians involved in the management of obesity should address the combination of alexithymic traits and emotional distress by planning effective client-focused interventions., (© 2019 John Wiley & Sons, Ltd and Eating Disorders Association.)

Psychiatric comorbidities are prevalent in youth eating disorders. In a sample of 1,906 youth from the United States (49.2% female), followed from elementary school into high school, we found support for a model to help explain this comorbidity. Endorsement of binge eating in fifth grade (elementary school) predicted increases in negative urgency, negative affect, and lack of planning in seventh grade (middle school). In turn, seventh grade negative urgency predicted increases in 10th grade (high school) externalizing dysfunction (binge eating, alcohol use problems, and smoking) and internalizing dysfunction (depressive symptoms). Seventh grade negative affect predicted increases in 10th grade binge eating and depressive symptoms. Seventh grade lack of planning predicted increases only in 10th grade externalizing behaviours. Early engagement in binge eating may elevate risk for multiple forms of dysfunction, at least in part due to its prediction of high-risk personality change in middle school., (© 2019 John Wiley & Sons, Ltd and Eating Disorders Association.)