An Open Trial Targeting Food Cue Reactivity and Satiety Sensitivity in Overweight and Obese Binge Eaters.

Data suggests that individuals who binge eat are more responsive to food cues in the environment and less sensitive to satiety cues. The aim of this open trial was to evaluate the feasibility, acceptability, and initial effectiveness of a novel treatment grounded in Schachter's externality theory targeting food cue reactivity and satiety responsiveness with obese adults who binge eat. Treatment was provided in groups, and utilized appetite monitoring, cue-exposure treatment, in vivo exercises, self-monitoring, and coping skills. Twenty-eight overweight and obese adults who binge eat (82% female; mean age = 47.5 years [SD = 12.8]; BMI = 38.9 [SD = 10.3]; 79% White non-Hispanic) participated in a 4-month group-based treatment program. Assessments were conducted at baseline, posttreatment, and 3-month follow-up time points. Results indicated that this treatment was well accepted and had high retention at posttreatment. Initial effectiveness showed significant decreases in BMI, and improvements in loss of control and overeating episodes, food responsiveness, and power of food. The majority of results were maintained at the 3-month follow-up time point. This open trial provides preliminary evidence for the feasibility, acceptability, and initial effectiveness of this treatment on both eating disorder symptoms and weight in obese adults who binge eat. Because these data are preliminary, further treatment development and randomized controlled studies are needed.

Neurobiologically informed treatment for adults with anorexia nervosa: a novel approach to a chronic disorder.

Anorexia nervosa (AN) is a severe and debilitating disorder with significant medical and psychological sequelae. To date, there are no effective treatments for adults, resulting in high rates of chronicity, morbidity, and mortality. Recent advances in brain imaging research have led to an improved understanding of etiology and specific neurobiological mechanisms underlying symptoms. Despite this, there are no treatments focused on targeting symptoms using this empirically supported mechanistic understanding of the illness. Updated treatment approaches focused on targeting neurobiological mechanisms underlying core AN symptomatology are necessary to improve treatment out-comes for this population. Neurobiologically Enhanced With Family Eating Disorder Trait Response Treatment (NEW FED TR) is a neurobiologically informed treatment targeting key temperament constructs associated with the illness through the delivery of psychoeducation and skills training to patients and nominated carers.

La anorexia nerviosa (AN) es un trastorno grave y debilitante con importantes secuelas médicas y psicológicas. A la fecha no existen tratamientos efectivos para adultos, lo que lleva a altas frecuencias de cronicidad, morbilidad y mortalidad. Avances recientes en la investigación imaginológica han conducido a un progreso en la comprensión de la etiología y de los mecanismos neurobiológicos específicos de los síntomas subyacentes. A pesar de esto, no existen tratamientos enfocados en los síntomas blanco que utilicen esta comprensión mecanicista con un sus-tento empírico de la enfermedad. Para mejorar los resultados terapéuticos para esta población es necesario que las aproximaciones terapéuticas actuales se enfoquen en los mecanismos neurobiológicos blanco a la base de la sintomatología central de la AN. El NEW FED TR (Neuro-biologically Enhanced With Family Eating Disorder Trait Response Treatment) es un tratamiento neurobiológicamente informado que apunta a constructos temperamentales clave asociados con la enfermedad a través de la entrega de psicoeducación y entrenamiento en herramientas para pacientes y cuidadores designados.

L'anorexie mentale est une maladie sévère et invalidante aux séquelles médicales et psychologiques importantes. À ce jour, il n'existe pas de traitement efficace chez l'adulte ; les taux de chronicité, morbidité et mortalité sont donc élevés. Des avancées récentes de la recherche en imagerie cérébrale ont permis de mieux comprendre l'étiologie et les mécanismes neurobiologiques spécifiques à l'origine des symptômes. Mais malgré cela, aucun traitement ciblant les symptômes et fondé sur cette compréhension mécanistique de la maladie sur des bases empiriques n'a vu le jour. Améliorer les résultats des traitements pour cette population nécessite d'actualiser ceux qui ciblent les mécanismes neurobiologiques au coeur de l'anorexie mentale. Le NEW FED TR (Neurobiologically Enhanced With Family Eating Disorder Trait Response Treatment) est un programme thérapeutique neurobiologique ciblant les concepts de personnalité clés associés à la maladie en faisant bénéficier les patients et les soignants désignés de mesures psychoéducatives et d'acquisition de compétences.

A Brief, Intensive Application of Multi-Family-Based Treatment for Eating Disorders.

There is a continued need to improve upon the efficacy and availability of treatments for anorexia nervosa. Family-based therapy for anorexia nervosa demonstrates strong empirical evidence; however, trained treatment providers are limited and a subsample of participants receiving the treatment fail to respond. The intensive family treatment program is a brief, time-limited, multi-family program that trains families of adolescents with eating disorders to oversee their adolescents' recovery at home by providing psychoeducation, skills training, and immersive practice over the course of a 5-day period. This article provide a description of the program by summarizing underlying theoretical principles and key therapeutic components.

Parent Coaching Model for Adolescents With Emotional Eating.

A significant proportion of both healthy and treatment-seeking youth report eating for emotional reasons. Emotional eating (EE) is associated with medical and psychological sequelae including overeating and eating disorder symptoms. Youth with EE are thought to have a predisposition toward a high level of emotional sensitivity, with a tendency to experience emotions intensely, and for a long duration. Interventions are needed to address emotion dysregulation associated with EE. Parent-focused interventions that emphasize training parents to respond to emotion dysregulation in their children have the potential to reduce the incidence of EE. This article describes an emotion-focused parent training intervention for youth who engage in EE.

Short-term intensive family therapy for adolescent eating disorders: 30-month outcome.

Family therapy approaches have generated impressive empirical evidence in the treatment of adolescent eating disorders (EDs). However, the paucity of specialist treatment providers limits treatment uptake; therefore, our group developed the intensive family therapy (IFT)-a 5-day treatment based on the principles of family-based therapy for EDs. We retrospectively examined the long-term efficacy of IFT in both single-family (S-IFT) and multi-family (M-IFT) settings evaluating 74 eating disordered adolescents who underwent IFT at the University of California, San Diego, between 2006 and 2013. Full remission was defined as normal weight (≥ 95% of expected for sex, age, and height), Eating Disorder Examination Questionnaire (EDE-Q) global score within 1 SD of norms, and absence of binge-purging behaviours. Partial remission was defined as weight ≥ 85% of expected or ≥ 95% but with elevated EDE-Q global score and presence of binge-purging symptoms (<1/week). Over a mean follow-up period of 30 months, 87.8% of participants achieved either full (60.8%) or partial remission (27%), while 12.2% reported a poor outcome, with both S-IFT and M-IFT showing comparable outcomes. Short-term, intensive treatments may be cost-effective and clinically useful where access to regular specialist treatment is limited.

Design and implementation of a study evaluating extinction processes to food cues in obese children: the Intervention for Regulations of Cues Trial (iROC).

Obesity and its health sequelae affect a significant portion of children in the United States. Yet, the current gold-standard family-based behavioral weight-loss treatments are only effective for one-third of children long-term. Therefore, we developed iROC (Intervention for Regulation of Cues) to specifically target a method to decrease overeating in overweight children, based on learning theory, to inform and enhance interventions targeting diet and obesity in youth. This study will rigorously test extinction processes as a method of decreasing physiological and psychological responses to food cues in overweight and obese children. Through exposing children to their highly craved foods, and 'training the brain and body' to decrease overeating, we are hoping to produce longer-lasting weight loss or weight-gain prevention over time.

Temperament-based treatment for anorexia nervosa.

Anorexia nervosa (AN) tends to be a chronic and deadly disorder with no proven treatments that reverse core symptoms in adults. New insight into neurobiological mechanisms that contribute to symptoms may support development of more effective interventions. We describe the development of a temperament-based treatment for AN on the basis of empirically supported models. It uses a systemized approach and takes into consideration an understanding of how neurobiological mechanisms are expressed through behaviour and personality and contribute to specific AN symptomatology. This model integrates the development of AN-focused constructive coping strategies with carer-focused strategies to manage temperament traits that contribute to AN symptomatology. This intervention is consistent with the recent Novel Interventions for Mental Disorders initiative mandating that treatment trials follow an experimental medicine approach by identifying underlying mechanisms that are directly targeted by the intervention to influence symptoms.

Relationships between body satisfaction and psychological functioning and weight-related cognitions and behaviors in overweight adolescents.

PURPOSE: To examine how differences in body satisfaction may influence weight control behaviors, eating, weight and shape concerns, and psychological well-being among overweight adolescents. METHODS: A group of 103 overweight adolescents completed a survey assessing body satisfaction, weight control behaviors, eating-related thoughts and behaviors, importance placed on thinness, self-esteem, anger, and symptoms of depression and anxiety between 2004 and 2006. Logistic regression analyses compared overweight adolescents with high and low body satisfaction. RESULTS: Higher body satisfaction was associated with a lower likelihood of engaging in unhealthy weight control behaviors, less frequent fears of losing control over eating, and less importance placed on thinness. Overweight adolescents with higher body satisfaction reported higher levels of self-esteem and were less likely to endorse symptoms of depression, anxiety, and anger than overweight adolescents with lower body satisfaction. CONCLUSIONS: Adolescents with higher body satisfaction may be protected against the negative behavioral and psychological factors associated with overweight.