Gender differences in individuals with obesity and binge eating disorder: A retrospective comparison of phenotypical features and treatment outcomes.

OBJECTIVE: Phenotypical comparisons between individuals with obesity without binge eating disorder (OB) and individuals with obesity and comorbid binge eating disorder (OB + BED) are subject to ongoing investigations. At the same time, gender-related differences have rarely been explored, raising the question whether men and women with OB and OB + BED may require differently tailored treatments. METHOD: We retrospectively compared pre- versus post-treatment data in a matched sample of n = 180 men and n = 180 women with OB or OB + BED who received inpatient treatment. RESULTS: We found that men displayed higher weight loss than women independent of diagnostic group. In addition, men with OB + BED showed higher weight loss than men with OB after 7 weeks of treatment. CONCLUSIONS: The present findings add to an emerging yet overall still sparse body of studies comparing phenotypical features and treatment outcomes in men and women with OB and OB + BED; implications for further research are discussed. CLINICAL TRIAL REGISTRATION: The study was prospectively registered with the German Clinical Trial Register as part of application DRKS00028441.

Very-Low-Calorie Ketogenic Diet: A Potential Treatment for Binge Eating and Food Addiction Symptoms in Women. A Pilot Study.

BACKGROUND: many patients who struggle to lose weight are unable to cut down certain ultra-processed, refined types of food with a high glycemic index. This condition is linked to responses similar to addiction that lead to overeating. A very-low-calorie ketogenic diet (VLCKD) with adequate protein intake could be considered a valid dietary approach. The aim of the present study was to evaluate the feasibility of a VLCKD in women with binge eating and/or food addiction symptoms. METHODS: subjects diagnosed with binge eating and/or food addiction symptoms (measured with the Binge Eating Scale and the Yale Food Addiction Scale 2.0) were asked to follow a VLCKD with protein replacement for 5-7 weeks (T1) and a low-calorie diet for 11-21 weeks (T2). Self-reported food addiction and binge eating symptoms and body composition were tested at T0 (baseline) and at the end of each diet (T1 and T2 respectively); Results: five women were included in the study. Mean age was 36.4 years (SEM = 4.95) and mean BMI was 31.16 (SEM = 0.91). At T0, two cases of severe food addiction, one case of mild food addiction, one case of binge eating with severe food addiction, and one case of binge eating were recorded. Weight loss was recorded at both T1 and T2 (ranging from 4.8% to 11.6% of the initial body weight at T1 and from 7.3% to 12.8% at T2). No case of food addiction and/or binge eating symptoms was recorded at T2. Muscle mass was preserved. CONCLUSIONS: recent findings have highlighted the potential therapeutic role of ketogenic diets for the treatment of addiction to high-calorie, ultra-processed and high-glycemic food. Our pilot study demonstrates the feasibility of a ketogenic diet in women with addictive-like eating disorders seeking to lose weight.

Overeaters Anonymous: An Overlooked Intervention for Binge Eating Disorder.

The purpose of this communication is to provide an overview as well as the strengths and weaknesses of Overeaters Anonymous (OA) as an intervention for binge eating disorder treatment. Binge eating disorder is associated with low remission rates, high relapse rates, treatment dissatisfaction, and high rates of failure to receive treatment attributed to stigma, misconceptions, lack of diagnosis, access to care, and inadequate insurance coverage. New interventions are needed that can overcome these barriers. OA is a twelve-step program and established fellowship for individuals who self-identify as having problematic relationships with food or eating. OA can be referred clinically or sought out by an individual confidentially, without a diagnosis, and free of charge. OA's Nine Tools, Twelve Steps, and Twelve Traditions can provide structure, social support, and open, anonymous sharing that fosters a sense of connection and belonging. This may provide benefit to individuals who value structure and social support in their recovery. The tradition of anonymity may also create some challenges for conducting research and may explain the shortage of empirical support. This commentary reviews existing research findings on the effectiveness of twelve-step interventions and OA. Common misunderstandings about and within OA are also addressed and OA's limitations are discussed. Overall, OA provides a promising option for binge eating disorder treatment that warrants clinical research on its feasibility and efficacy in a way that respects and protects its tradition of anonymity.

Eating behaviour and symptom trajectories in patients with a history of binge eating disorder during COVID-19 pandemic.

OBJECTIVE: A history of an eating disorder (ED) might constitute a risk for symptom deterioration and relapse during COVID-19 pandemic. This longitudinal study investigates ED symptom trajectories until the first COVID-19 lockdown in Spring 2020 in patients with a history of binge eating disorder (BED). METHOD: Participants of the randomised-controlled BED treatment trial IMPULS participated in a re-assessment directly after the first COVID-19 lockdown in Germany. We used expert-rated clinical interviews and self-report to investigate binge eating (BE) frequency, ED and general psychopathology, distress, emotion regulation and sense of coherence. Symptom trajectories were analysed for baseline when entering the trial, end of trial participation and the time point directly after lockdown. BE frequency was assessed on a recall basis for 4 weeks directly before lockdown and 4 weeks during lockdown. RESULTS: BE frequency, general ED pathology and depressive symptoms markedly increased after as compared to before the COVID-19 outbreak. Individuals scoring high on reappraisal as emotion regulation strategy and sense of coherence scored lower on general ED pathology. CONCLUSION: Individuals with a history of an ED are at risk for symptom deterioration and relapse during the pandemic. Intervention and service dissemination strategies are needed to support vulnerable groups throughout the pandemic.

The Reward Re-Training protocol: A novel intervention approach designed to alter the reward imbalance contributing to binge eating during COVID-19.

Reduced exposure to social reward during the COVID-19 pandemic may result in both reduced reward response to day-to-day life activities and elevated reward response to substances or naturally rewarding stimuli (e.g., food). The combined hypo- and hyper-reward responses results in a reward imbalance, which has been noted as a relevant maintenance factor for eating disorders (EDs) characterized by binge eating. This registered report describes the protocol for a pilot randomized controlled trial (RCT) comparing supportive therapy to a novel treatment targeting reward imbalance (Reward Re-Training; RRT) for individuals with binge eating. Aims of the current study include to confirm feasibility and acceptability of RRT, to evaluate the ability of RRT to engage critical targets, and to provide preliminary estimates of efficacy in reducing ED symptoms at both posttreatment and 3-month follow-up. Sixty participants will be randomized to either RRT or supportive therapy. For both conditions, treatment will be delivered in 10 weekly group outpatient therapy sessions conducted remotely using videoconferencing software. Assessments will be conducted at baseline, mid-treatment, posttreatment, and 3-month follow-up to measure feasibility, acceptability, critical treatment targets (i.e., reward to day-to-day life activities, reward to palatable foods, social isolation, and loneliness), and ED symptoms.