Binge eating and eating-related cognitions and behavior in ethnically diverse obese women.

OBJECTIVE: To examine binge eating and eating-related cognitions and behavior in a sample of ethnically diverse women who are severely obese and seeking bariatric surgery. RESEARCH METHODS AND PROCEDURES: Female bariatric surgery candidates (62 African Americans, 18 Latinas, 130 whites) completed questionnaires on binge eating and eating-related cognitions and behavior and completed a structured clinical interview to confirm binge-eating disorder diagnosis. RESULTS: Ethnic minorities and whites did not differ in rates of binge-eating disorder (26.3%), binges per week (M = 0.95), or dietary restraint. Ethnic minorities reported less disinhibition, and there was a trend to report less hunger awareness than whites. After controlling for BMI and education, ethnicity accounted for significant variance in disinhibition (4%; p < 0.01). Ethnic minorities were younger, became overweight at a later age, and were overweight for fewer years than whites. DISCUSSION: Results suggest that ethnicity exerts an important influence on disinhibition and that ethnic differences are not caused by BMI or education. Findings point to the need to continue to investigate the role of ethnicity, binge eating, and disinhibition in severely obese women, so that culturally appropriate services can be provided.

Family-based therapy for adolescents with bulimia nervosa.

Bulimia nervosa is occurring with increasing frequency among adolescents. Yet, no studies have examined effective treatments for this patient population. Involving the family in the treatment of adolescents with anorexia nervosa has proven to be helpful. A small series of cases has demonstrated that family-based treatment might also be beneficial for adolescents with bulimia nervosa. Moreover, treatment studies for adolescents with anorexia nervosa have demonstrated that family-based treatment does benefit binge eating/purging anorexics. Therefore, preliminary evidence seems to support the use of family-based treatment for adolescent bulimia nervosa. In this article, we review our current knowledge of family-based treatment for adolescents with an eating disorder, and present a case that has completed treatment in order to demonstrate the outline and main interventions of this manualized treatment. While this case demonstrates the successful resolution of bulimia in an adolescent female, at least in the short term, the efficacy of family-based treatment for this patient population is yet to be determined, and is currently being examined in a randomized controlled study at The University of Chicago.

Quality of life after gastric bypass surgery: a cross-sectional study.

OBJECTIVE: Numerous reports document significant weight loss after gastric bypass; however, there is little objective data on postsurgical changes in health-related quality of life (HRQL). RESEARCH METHODS AND PROCEDURES: This study examined HRQL in four groups of patients: presurgery (T1), several weeks postsurgery (T2), 6 months postsurgery (T3), and 1 year postsurgery (T4). Subjects were given three HRQL measures: the short form 36 (SF-36), the Impact of Weight on Quality of Life-Lite Questionnaire (IWQOL-Lite), and the Bariatric Analysis and Reporting Outcome System (BAROS). Subjects also completed the Beck Depression Inventory (BDI) and the Rosenberg Self-Esteem Scale (RSE). RESULTS: There were no significant differences among the groups on demographics or presurgical body mass index. Results showed significant differences between T1 and T2 on several SF-36 and IWQOL-Lite subscales, as well as the RSE and BDI. Significant differences were found on all measures between T2 and T3. Significant differences were found on all subscales of the IWQOL-Lite, but no subscales of the SF-36, the RSE, or the BDI between T3 and T4. DISCUSSION: This study is the first to objectively document these differences in several objective measures of HRQL, depression, and self-esteem after gastric bypass in a large sample. It is notable that many differences are apparent within several weeks after surgery. Furthermore, results indicate that the IWQOL-Lite may be more sensitive than the SF-36 to the changes of quality of life that gastric bypass patients report.

The effects of Roux-en-Y gastric bypass surgery on body image.

BACKGROUND: Numerous studies examine the physical effects of Roux-en-Y gastric bypass (RYGBP) surgery on morbid obesity. However, the effects of this surgery on psychosocial issues such as body image have not been extensively studied. METHODS: This pilot study used a cross-sectional design to examine the effects of RYGBP surgery on patients' perceived body image. Four groups (n = 20) were assessed for perceived change in body image at 4 time intervals. These included pre-surgery, 1 to 3 weeks post-surgery, 6-months post-surgery, and 1-year post-surgery, with two measures of body image. One-way ANOVA was applied, with body image measures as the dependent variables, and time since surgery (group) as the independent variable. Planned post-hoc t-tests were applied to assess the differences between specific groups (pre vs. 1 week, pre vs. 6 months post, 6 months post vs. 1 year post). RESULTS: Results of the one-way ANOVAs revealed significant improvement on perceptions of body image over time following surgery. Follow-up t-tests revealed that the most significant improvement occurred between pre-surgery and 6 months post-surgery. Although smaller, the change between 6 months post-surgery and 1 year post-surgery was also significant. CONCLUSION: While RYGBP results in numerous medical and physical benefits, this study reveals that there are also dramatic improvements in perceived body image, demonstrating the impact of this surgery on a patient's psychosocial health.

Anorexia nervosa with comorbid psychosis and borderline mental retardation: a case report.

UNLABELLED: Anorexia nervosa (AN) is often associated with comorbid depression or anxiety, but rarely with mental retardation or psychosis. METHODS: The present report describes the case of a 22 year-old woman who met diagnostic criteria for anorexia nervosa, borderline mental retardation, and schizoaffective disorder. RESULTS AND DISCUSSION: The case highlights the difficulties in differential diagnosis with these seemingly incompatible disorders. It also provides some insights into the unclear relationship between anorexia nervosa and these comorbid conditions.