ABSTRACT
Binge eating is a central diagnostic feature of bulimia nervosa (BN) and binge-eating disorder (BED), yet the phenomenon of bingeing has not been adequately defined, and there is considerable variability in how individuals label eating episodes as binges. We examined the agreement among binge-eating individuals, non-eating-disordered peers, and professional dietitians over whether particular eating episodes were binges. Twenty-nine females with BED, fifteen nonclinical binge eaters (NCB), three peer judges, and three dietitians rated a sample of eating episodes of the binge-eating individuals as either binges or nonbinges based on the types and amounts of food eaten as well as the duration of each eating episode. BED participants labeled a significantly higher proportion of their intakes as binges relative to NCB participants. Peer judges were more likely than were dietitians to label participants' eating episodes as binges. Agreement within dietitian and peer groups was poor to fair, whereas agreement between these groups was fair. Finally, agreement between participants and the external judges (i.e., peers, dietitians) was poor. Possible explanations for these findings as well as implications for the diagnosis of BN and BED are discussed.
Subject(s)
Feeding Behavior/classification , Feeding and Eating Disorders/diagnosis , Terminology as Topic , Adult , Attitude of Health Personnel , Female , Humans , Observer Variation , Peer Group , Self-Assessment , Social PerceptionABSTRACT
The present investigation studied the relationship between symptoms of menstrual distress and macronutrient intake, eating behavior, and exercise in healthy women. Twenty-six normally menstruating women with no complaints of menstrual distress completed a disguised questionnaire on menstrual symptoms and monitored the type and amount of food consumed as well as the type and duration of exercise during a full menstrual cycle. Menstrual cycle phases were determined by the presence of menses, ovarian hormonal assays, and basal temperature monitoring. Reports of pain, water retention, negative affect, behavior change, and arousal were significantly higher (p < .05 or better) in the perimenstruum when compared to the follicular and luteal phases. During the perimenstruum, a higher energy intake of carbohydrate was associated with higher ratings of negative affect (p < .01) and impaired performance/decreased activity (p < .05). Lower energy intake of protein was associated with higher ratings of well being (p < .05). Overeating and dieting behavior were related to greater water retention (p < .01), autonomic reactions (p < .05), and appetite (p < .05). The amount of aerobic exercise in contrast to the intensity was related to lower water retention (p < .01), autonomic reactions (p < .05), and appetite (p < .01). Carbohydrate consumption, eating behavior, and regular exercise are reliably associated with menstrual distress and deserving of experimental evaluation as treatment interventions for menstrual distress.
Subject(s)
Exercise/psychology , Feeding Behavior/psychology , Premenstrual Syndrome/psychology , Adolescent , Adult , Appetite/physiology , Arousal/physiology , Autonomic Nervous System/physiopathology , Diet Records , Dietary Carbohydrates/administration & dosage , Dietary Proteins/administration & dosage , Energy Intake/physiology , Estrogens/blood , Exercise/physiology , Female , Follicle Stimulating Hormone/blood , Humans , Luteinizing Hormone/blood , Premenstrual Syndrome/physiopathology , Progesterone/blood , Water-Electrolyte Balance/physiologyABSTRACT
Changes in body image across the menstrual cycle and the relationship between these changes and menstrual distress were investigated in an effort to identify determinants of body dissatisfaction. Twenty-six normally cycling women between 18-40 years of age and 90-115% of ideal body weight, with no history of an eating disorder, completed a series of body image measures and a measure of menstrual distress during three menstrual cycle phases: perimenstrual, follicular, and luteal. These phases were identified with serum levels of ovarian hormones and basal body temperature. Results indicated that body dissatisfaction as measured by the number of body-related negative thoughts and anxiety about appearance was significantly highest during the perimenstrual phase. In contrast, measures of body size perception remained stable. Several somatosensory and psychological symptoms of menstrual distress were significantly associated with body dissatisfaction during the perimenstrual phase including, water retention, autonomic reactivity, control, negative affect, and impaired concentration. This association of body dissatisfaction and menstrual distress strongly suggests that menstrual cycle changes play a significant role in body image.
Subject(s)
Body Image , Menstrual Cycle/physiology , Adolescent , Adult , Affect , Body Weight , Female , Follicular Phase , Humans , Luteal Phase , Menstrual Cycle/psychology , Surveys and QuestionnairesABSTRACT
The present study examined the psychopathology associated with binge eating disorder (BED), a new diagnostic category proposed for DSM-IV to classify patients with significant binge eating problems in the absence of purging. Self-report measures of psychopathology (e.g., depression, anxiety) and body image disturbance were administered to 72 women who prospectively (1) met criteria for BED (DSM-IV criteria), (2) reported frequent bingeing but did not meet BED criteria, and (3) denied problems with eating. Subjects satisfying BED criteria reported higher levels of psychopathology than normals on all measures and subclinical binge eaters scored between these two groups, but they were closer to subjects without eating problems. The pattern of results was essentially unchanged when corrected for weight. BED subjects and subclinical binge eaters were less satisfied with their bodies than were normal controls. These findings suggest that BED is not only characterized by frequent bingeing, but more importantly is associated with elevated psychopathology. Overall, these results lend support to the diagnostic criteria proposed for BED.
Subject(s)
Bulimia/psychology , Hyperphagia/psychology , Adult , Anxiety Disorders/classification , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Body Image , Bulimia/classification , Bulimia/diagnosis , Depressive Disorder/classification , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Diagnosis, Differential , Diet, Reducing/psychology , Female , Humans , Hyperphagia/classification , Hyperphagia/diagnosis , Obesity/psychology , Personality Inventory , Psychiatric Status Rating Scales , PsychopathologyABSTRACT
Proposed binge eating disorder (BED) diagnostic criteria were investigated to provide necessary psychometric characteristics and explore their utility in assessment. One hundred four subjects (52 self-referred bingers, 52 comparison subjects) completed an initial administration of the Questionnaire of Eating and Weight Patterns (QEWP). The results supported the ability of the two core BED criteria (i.e., episodic overeating, loss of control) to discriminate between clinical and nonclinical binge eaters. Thirty-nine of the self-referred and 40 of the comparison subjects completed a second QEWP administration 3 weeks later. Results indicated that the BED diagnosis was moderately stable over the 3-week interval (kappa = .58, combined sample). Using self-monitoring data completed by the self-referred subjects, predictive efficiency analyses indicated that the QEWP was able to identify both high and low probability binge eaters. Implications of the findings for the definition, assessment, and utility of the BED diagnosis are discussed.
