Relations between pure dietary and dietary-negative affect subtypes and impulsivity and reinforcement sensitivity in binge eating individuals.

To investigate potential predictors of the severity of binge eating disorder (BED), two subtypes of patients with the disorder, a pure dietary subtype and a dietary-negative affect subtype, were identified. This study investigated the relationships between the two subtypes and impulsivity and reinforcement sensitivity. Ninety-two women meeting threshold and subthreshold criteria for BED diagnosis filled out questionnaires to determine eating disorder severity, impulsivity and reinforcement sensitivity before and after participating in an online guided self-help program for BED. Cluster analyses revealed a pure dietary subtype (N=66, 71.7%) and a dietary-negative affect subtype (N=26, 28.3%). Compared to the pure dietary subtype, the dietary-negative affect subtype reported a higher frequency of objective binge episodes, more severe eating disorders, higher urgency scores (defined as a tendency to act rashly in the context of negative affect), a greater sensitivity to punishment, and a higher dropout rate during treatment. These findings suggest that BED patients in the dietary-negative affect subtype exhibit heightened anxiety and are highly impulsive, especially in contexts of negative affect. For these individuals, psychological interventions for BED should focus on inhibiting automatic responses to negative emotions.

Acceptance and efficacy of a guided internet self-help treatment program for obese patients with binge eating disorder.

INTRODUCTION: A significant percentage of obese patients suffer from binge eating disorder (BED), with negative consequences on psychological health, quality of life, weight loss treatment and maintenance. Cognitive behavioral therapy (CBT), delivered in traditional or self-help format, is effective in reducing BED symptoms. To improve dissemination, a self-help treatment program composed of eleven CBT based modules was implemented on the Internet and evaluated in a population of adult obese patients with BED. METHOD: Forty-two obese BED patients wait-listed for a multi-disciplinary obesity treatment took part in the study. Twenty-two patients completing the six-month online guided self-help treatment program were compared to a control group of twenty patients without intervention. Both groups were evaluated before and after six months of Internet self-help treatment or waiting list. A follow-up evaluation was carried out six months later. RESULTS: Participants in the online self-help treatment program showed higher binge eating abstinence rates, lower EDE-Q shape and weight concerns, and improved TFEQ disinhibition of eating and hunger scores compared to the control group. They also scored better on psychological health and quality of life measures after intervention, and gains were maintained at follow-up. No effect was found regarding BMI. The number of modules completed was correlated with a better quality of life improvement at post evaluation. Participants rated the program as useful and easy to use. CONCLUSION: The Internet seems to be a valuable tool for disseminating CBT for BED obese patients. Acceptance of new technology was good in this population. Further research is needed with a larger sample to corroborate these results.

Obesity and the four facets of impulsivity.

OBJECTIVE: Obesity is a complex condition involving biological, psychological, sociocultural and environmental components. Impulsivity seems to be a particularly important factor. Whiteside and Lynam recently proposed dividing impulsivity into four separate dimensions: Urgency, lack of Premeditation, lack of Perseverance and Sensation Seeking (associated with a tendency to exaggerate the impact of rewards). The objective of this article is to examine how obesity and eating disorder symptoms may be related to the four facets of impulsivity. METHODS: Whiteside and Lynam's Impulsive Behavior Scale, the Sensitivity to Punishment and Sensitivity to Reward Questionnaire, the Eating Disorder Examination Questionnaire and the Mizes Anorectic Cognitions Questionnaire were used to explore the association between the cognitive and motivational facets of impulsivity and obesity in 47 overweight or obese persons with eating disorders and 47 normal-weight controls. RESULTS: Results suggest that overweight and obese persons have higher levels of Urgency, lack of Perseverance and Sensitivity to Reward. CONCLUSION: These results suggest that obese and overweight persons have difficulty inhibiting automatic or dominant behavior and intrusive thoughts and a higher sensitivity to reward. PRACTICE IMPLICATIONS: Overweight and obese persons may benefit from psychological interventions targeting self-control problems associated with impulsive eating behaviors.

[Managing impulsivity in obesity with problem solving]. / Nutrition-obésité. Gérer l'impulsivité dans l'obésité par la résolution de problème.

Among factors involved in binge eating episodes of our obese patients, impulsivity plays an important role. The model of Whiteside and Lynam describes four facets of impulsivity (urgency, lack of premeditation, lack of perseverance, sensation seeking). This multifaceted construct sheds light on our patients' impulsive behaviours towards food. To help our patients manage their impulsivity, problem solving technique is described in details. It can be effective in helping patients to cope their binge eating episodes since problem solving can initiate action and change habits.