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.

COVID-19-related changes in eating disorder pathology, emotional and binge eating and need for care: a systematic review with frequentist and Bayesian meta-analyses.

PURPOSE: The COVID-19 pandemic has been a leading cause of stress and feelings of loss of control, both of which have been related to eating disorder (ED) pathology onset and deterioration. We aim to estimate the magnitude of changes in the prevalence rates of, and indicators for, ED psychopathology in the face of the COVID-19 pandemic. METHOD: Pre-registered systematic review with frequentist and Bayesian meta-analyses. Searches for eligible studies were performed in PubMed, Web of Science and pre-print servers until January 15 2023. RESULTS: Our searches yielded 46 eligible studies reporting on a total of 4,688,559 subjects. These data provide strong evidence indicating increased rates of diagnosed and self-reported ED's and a concordant increased need for care in the face of the pandemic. ED symptom severity scores in patients were not elevated during the pandemic, except for those related to anorexia nervosa. On average, people in the general population report relatively high levels of emotional and binge eating during the pandemic, although the evidential strength for these associations is only anecdotal to moderate. Moderators of between-study heterogeneity were not detected. CONCLUSIONS: Altogether, our results suggest that the COVID-19 pandemic is associated with a wide spread negative effect on ED pathology in patient samples and the general population. The development of online prevention and intervention programs for EDs during stressful times like a pandemic is encouraged. A limitation is that the results reported here may be prone to biases, amongst others, self-report bias. LEVEL OF EVIDENCE: Level I, systematic review and meta-analysis. PREREGISTRATION: Prospero [ https://www.crd.york.ac.uk/prospero ] ID: CRD42022316105.

Shifting age of child eating disorder hospitalizations during the Covid-19 pandemic.

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.

The effects of the COVID-19 pandemic on disordered eating symptoms in women: A 49-day, daily study before and during the outbreak in the United States.

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).

A community-based feasibility randomized controlled study to test food-specific inhibitory control training in people with disinhibited eating during COVID-19 in Italy.

PURPOSE: The aim of this study was to expand the evidence on the feasibility and impact of food-specific inhibitory control training in a community sample of people with disinhibited eating. METHODS: Recruitment and data collection were conducted during the COVID-19 outbreak, in Italy. Ninety-four adult individuals with disinhibited eating were randomised to one of two conditions: App-based food-specific inhibitory control training or waiting list. Participants were assessed at baseline, end of intervention (2 weeks following baseline) and follow-up (one week later). The assessment measures included questionnaires about eating behaviour and mood. RESULTS: Seventy-three percent of the sample reported a diagnosis of binge eating disorder, and 20.4% a diagnosis of bulimia nervosa. Retention rates were 77% and 86% for the food-specific inhibitory control training and the waiting list conditions, respectively. Almost half of the participants allocated to the training condition completed the "recommended" dose of training (i.e., 10 or more sessions). Those in the training condition reported lower levels of wanting for high-energy dense foods (p < 0.05), a trend for lower levels of perceived hunger (p = 0.07), and lower levels of depression (p < 0.05). Binge eating symptoms, disinhibition, wanting for high-energy dense foods, stress and anxiety were significantly lower at end of intervention, compared to baseline (p < .05). CONCLUSION: Findings corroborated the feasibility of food-specific inhibitory control training, and its impact on high-energy dense foods liking. The study expands the evidence base for food-specific inhibitory control training by highlighting its impact on perceived hunger and depression. The mechanisms underlying these effects remain to be clarified. LEVEL OF EVIDENCE: Level I, Evidence obtained from at least one properly designed randomized controlled trials; systematic reviews and meta-analyses; experimental studies.

Food insecurity and its associations with bulimic-spectrum eating disorders, mood disorders, and anxiety disorders in a nationally representative sample of U.S. adults.

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.

COVID-19-Related Stress and Anxiety, Body Mass Index, Eating Disorder Symptomatology, and Body Image in Women from Poland: A Cluster Analysis Approach.

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, Mage = 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.

Weight Bias During the COVID-19 Pandemic.

PURPOSE OF REVIEW: This review explores potential sources of weight bias and stigma during the COVID-19 pandemic, including "quarantine-15" messages and discussion of obesity in media and public health campaigns. We examine evidence of the effects of weight bias on well-being during the pandemic and highlight unanswered questions to be addressed in future research. RECENT FINDINGS: Studies that have investigated weight change during stay-at-home orders have yielded mixed findings and relied predominantly on self-reported retrospective recall, thus providing weak evidence of a widespread "quarantine-15" effect. No studies to date have evaluated the effects on weight stigma and health of obesity-focused COVID-19 media and public health messages. Individuals with a history of experiencing weight bias may be more vulnerable to binge eating and psychological distress during the pandemic. Weight bias and stigma during the COVID-19 pandemic, and their effects on health and well-being, warrant greater investigation and consideration in public health efforts.

Increased emotional eating during COVID-19 associated with lockdown, psychological and social distress.

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.

Emotional eating, binge eating, physical inactivity, and vespertine chronotype are negative predictors of dietary practices during COVID-19 social isolation: A cross-sectional study.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) emerged and rapidly spread worldwide. Several countries have imposed lockdown and isolation in attempt to mitigate viral spread. However, social isolation has a negative effect on psychological aspects, increasing stress, fear, anxiety, anger and emotional disturbance, as well as affecting sleep pattern and the practice of physical activity. Negative emotions and lifestyle changes trigger overeating, consequently affecting dietary practices. The aim of this study was to verify the prevalence of lifestyle factors (i.e., sleep time/quality and practice of physical exercise), eating behavior dimensions, chronotype, and association with dietary practices (planning, domestic organization, food choice, ways of eating) in home confinement during the COVID-19 pandemic in São Paulo, Brazil. METHODS: This cross-sectional study was conducted between April 27 and May 25, 2020. An anonymous online questionnaire (Microsoft Forms) was used for data collection by the snowball method. We verified dietary practices (outcome), eating behavior, physical exercise practice, sleep quality and duration, and chronotype (exposure variables). Sex, age, educational and social status were assessed as covariates and confounders. We evaluated 724 adults (585 women and 139 men). Mean age was 32.6 y (±11.3) for women and 33.5 y (±10.5) for men. RESULTS: Emotional eating (EE) and binge eating (BE) were positively correlated (r = 0.66; P <0.001). Dietary practices were negatively correlated with BE (r = -0.41; P <0.001), EE (r = -0.33; P <0.001) and body mass index (r = -0.24; P <0.001). Linear regression demonstrated that EE (ß = -0.1351; t = -2.841; P = 0.005; ηp2 = 0.013), BE (ß = -0.2580; t = -5.612; P < 0.001; ηp2 = 0.050), no practice of physical exercise at home (ß = -0.4271; t = -5.933; P < 0.001; ηp2 = 0.055), being vespertine (ß = -0.3435; t = 2.076; P = 0.038; ηp2 = 0.019), and age (ß = -0.082; t = -2.210; P = 0.027; ηp2 = 0.008) are negative predictors of dietary practices. Finally, cognitive restraint (ß = 0.1407; t = 3.858; P < 0.001; ηp2 = 0.024), better sleep quality (ß = 0.1768; t = 2.506; P = 0.012; ηp2 = 0.010), receiving 4-10 wages per month (according to a minimum wage in Brazil that corresponds to US $ 183.01) (ß = 0.2568; t = 2.573; P = 0.10; ηp2 = 0.027) and 10 - 20 wages per month (ß = 0.4490; t = 3.726; P < 0.001; ηp2 = 0.027) are positive predictors of dietary practices. CONCLUSION: Eating behavior, physical exercise, sleep, and social factors can be important predictors for dietary practices during COVID-19 social confinement. Longitudinal studies in Brazil are needed to confirm these findings.