Category: Eating Disorders

While the start of college is a positive, momentous event for many young people, it also can be an episode that pushes some into a dangerous battle with eating disorders, says University of Alabama at Birmingham Associate Professor of Psychology Mary Boggiano, Ph.D., who fought her own battle against bulimia as a college student. Hear her story.

Stress can trigger an eating disorder, and for the college student who is away from home for the first time, the stress of moving into a totally different environment and meeting new people can make them more susceptible to developing an eating disorder, says Boggiano. Even new positive events are processed by the brain as stressful, she says.

"A lot of students have heard about the 'freshman 15,'" says Boggiano. "To keep from gaining weight, some students engage in risky behaviors such as excessive dieting or purging food. In many cases, people learn about the risky behaviors from others students in their dorm or over the Internet, so that obsession about weight can become infectious."

Boggiano says the common signs of an eating disorder include:

• A preoccupation with calculating calories, fat grams and carbohydrate grams
• A need to weigh oneself more than once a day
• Allowing the numbers on the scale to determine mood
• Exercising, skipping meals or purging after overeating
• Exercising to burn calories rather than for health or for fun
• An inability to stop eating once eating begins
• Eating in secret
• Feeling guilty, ashamed or disgusted after overeating
• Basing self-worth on looks or weight
• Worrying continuously about weight and body shape
• Abusing diet pills or laxatives

Eating disorders can lead to long-term health problems, and even death.

For any young people who suspect they might be developing an eating disorder, Boggiano encourages them to seek help at free campus counseling centers, through a pastor or family doctor or through programs like Overeaters Anonymous.

"Whatever you do, don't try to take care of it by yourself," says Boggiano. "It will only get worse."

Boggiano, who studies the psychobiology of eating disorders and obesity, knows this from personal experience as a young adult.

"My problems with bulimia nervosa actually began during my senior year in high school," she says. "I was a top student, salutatorian of my class. But, I became obsessed with my weight and the shape of my body. I started starving myself, but this led to binge eating and eventually vomiting after the binges, several times a day, and eventually I began abusing laxatives. When I started college, the disorder got worse."

The two most common forms of eating disorders are anorexia nervosa, when a person stops eating or eats very little to control their weight, and bulimia nervosa, when a person vomits or uses laxatives to get rid of the food they have eaten to prevent weight gain. Both types of eating disorders can eventually lead to serious health problems and even death.

Another form of eating disorder, binge eating disorders (or BED), is when an individual eats unusually large amounts of food, uncontrollably, in a short period of time until they are uncomfortable but do not purge or compensate afterward.

"This often leads to weight gain, which is upsetting to them," says Boggiano, "yet to overcome the distress, they turn to food. It's a vicious cycle." She is currently exploring brain markers of stress-induced binge-eating and the chemistry behind the action of high-fat and sugar foods to trigger relapses back to binge eating and obesity.

A new study from the University of Kent has found that people who wish to escape the 'meat paradox' — i.e., simultaneously disliking hurting animals and enjoying eating meat — may do so by denying that the animal they ate had the capacity to suffer.

Those participating in the study also reported a reduced range of animals to which they felt obligated to show moral concern. These ranged from dogs and chimps to snails and fish.

The study, the results of which are published in the August issue of Appetite, was conducted by Dr. Steve Loughnan, Research Associate at the University's School of Psychology, and colleagues in Australia.

Prior to their study, it was generally assumed that the only solutions to the meat paradox are for people to simply stop eating meat, a decision taken by many vegetarians, or to fail to recognize that animals are killed to produce meat. (Although few people live in true ignorance, some meat-eaters may live in a state of tacit denial, failing to equate beef with cow, pork with pig, or even chicken with chicken.)

Loughnan explained: "Some people do choose to stop eating meat when they learn that animals suffer for its production. An overwhelming majority do not. Our research shows that one way people are able to keep eating meat is by dampening their moral consideration of animals when sitting at the dinner table."

Loughnan also explained that, broadly speaking, their study has shown that when there is a conflict between people's preferred way of thinking and their preferred way of acting, it is their thoughts and moral standards that people abandon first — rather than changing their behavior. "Rather than change their beliefs about the animals' moral rights, people could change their behavior," he said. "However, we suspect that most people are unwilling to deny themselves the enjoyment of eating meat, and denying animals moral rights lets them keep eating with a clear conscience."

In addition to Loughnan, the study was co-authored by Nick Haslam, University of Melbourne, and Brock Bastian, University of Queensland.

Journal Reference:

1. Steve Loughnan, Nick Haslam, Brock Bastian. The role of meat consumption in the denial of moral status and mind to meat animals%u2606. Appetite, 2010; 55 (1): 156 DOI: 10.1016/j.appet.2010.05.043

 Research presented at the Annual Meeting of the Society for the Study of Ingestive Behavior finds that that feelings of hunger have less influence on how the brain responds to the smell and taste of food in overweight than healthy weight individuals.

The research team scanned the brains of healthy and overweight participants and found that the overweight participants had greater activity in many key brain regions that respond to the smell and taste of food. An important new finding was that the brain responses of healthy weight participants were associated with their feelings of hunger, whereas the responses of overweight participants did not depend on whether the participants felt hungry or full. Dana Small from The John B Pierce Laboratory and Yale University says, "We are all guilty of mindlessly reaching for a handful of peanuts or chips. The amygdala is a region of the brain important for orchestrating this behavior. Our findings show that feelings of fullness are effective in reducing amygdala responses in healthy but not overweight people."

In an environment that is rich in sights and smells of food, one factor that may contribute to overeating is whether eating serves to dampen the brain's responses to food cues that usually encourage eating. The team also reports that activation of the amygdala predicted weight gain by participants one year after the scanning session. "For some people feelings of fullness may provide a good brake on eating behavior. For others, the brake may be less effective, resulting in more eating in the absence of hunger, with subsequent weight gain," says Small.

This research was supported by grant R01 DK085579.

The lead author was Francois Chouinard-Decorte of The John B Pierce Laboratory and Yale University School of Medicine, New Haven CT, USA. Co-authors were J Felsted and DM Small of The John B Pierce Laboratory and Yale University School of Medicine, New Haven CT, USA

New research finds that a history of sexual abuse, regardless of the victim's gender or age when the abuse occurred, correlates strongly with a lifetime diagnosis of multiple psychiatric disorders.

In the July issue of Mayo Clinic Proceedings, researchers report that a history of sexual abuse is associated with suicide attempts, post-traumatic stress disorder, anxiety disorders, depression, and eating and sleep disorders. Additionally, associations between sexual abuse and depression, eating disorders, and post-traumatic stress disorder were strengthened by a history of rape.

"Survivors of sexual abuse are commonly seen in general medical practice," says Ali Zirakzadeh, M.D., Mayo Clinic Division of General Internal Medicine and principal investigator of the study. "Sexual abuse survivors face a challenging spectrum of physical and mental health symptoms, which results in high health care utilization, oftentimes without improvement in quality of life."

The study reports prevalence rates of sexual abuse in some populations are as high as 21 percent in adults and 33 percent in children. Furthermore, sexual abuse survivors can represent up to 25 percent of patient panels in primary care practices.

Researchers also explored why some abuse survivors do not experience psychiatric symptoms and suggest that genetic variability may confer a level of protection. "The protective effect of certain genes against the development of psychiatric disorders in abuse survivors is an intriguing prospect.

If confirmed, future testing may more effectively identify victims of abuse who are at increased risk to develop psychiatric disease and lead to the development of better interventions and treatment" says Dr. Zirakzadeh.

Dr. Zirakzadeh adds, "The good news for patients is that physicians are now more aware of the link between abuse and psychiatric illness so that abuse survivors may be more readily identified and referred to specialists for treatment. We hope that heightened awareness in clinical practice leads to improved outcomes for our patients."

Food presented in a virtual reality (VR) environment causes the same emotional responses as real food. Researchers writing in BioMed Central's open access journal Annals of General Psychiatry compared the responses of people with anorexia and bulimia, and a control group, to the virtual and real-life snacks, suggesting that virtual food can be used for the evaluation and treatment of eating disorders.

Alessandra Gorini from the Istituto Auxologico Italiano, Milan, Italy, worked with an international team of researchers to compare the effects of the exposure to real food, virtual food and photographs of food in a sample of patients affected by eating disorders. She said, "Though preliminary, our data show that virtual stimuli are as effective as real ones, and more effective than static pictures, in generating emotional responses in eating disorder patients."

The 10 anorexic, 10 bulimic and 10 control participants, all women, were initially shown a series of 6 real high-calorie foods placed on a table in front of them. Their heart rate and skin conductance, as well as their psychological stress were measured during the exposure. This process was then repeated with a slideshow of the same foods, and a VR trip into a computer-generated diner where they could interact with the virtual version of the same 6 items. The participants' level of stress was statistically identical whether in virtual reality or real exposure.

Speaking about the results, Gorini said, "Since real and virtual exposure elicit a comparable level of stress, higher than the one elicited by static pictures, we may eventually see VR being used to screen, evaluate, and treat the emotional reactions provoked by specific stimuli in patients affected by different psychological disorders."

Journal Reference:

1. Alessandra Gorini, Eric Griez, Anna Petrova and Giuseppe Riva. Assessment of the emotional responses produced by exposure to real food, virtual food and photographs of food in patients affected by eating disorders. Annals of General Psychiatry, 2010

For the first time, scientists have discovered a possible biological culprit in the development of eating disorders during puberty: a type of estrogen called estradiol.

The groundbreaking pilot study led by Michigan State University found that influence of one's genes on eating disorder symptoms was much greater in pubertal girls with higher levels of estradiol than pubertal girls with lower levels of estradiol. The study appears in the journal Psychological Medicine.

Lead investigator Kelly Klump, MSU associate professor of psychology, said previous research had established that eating disorders are influenced by both genetic and environmental factors once a girl hits puberty.

The underlying effects of the genes, however, were unknown.

"The reason we see an increase in genetic influences during puberty is that the genes for disordered eating are essentially getting switched on during that time," said Klump. "This research was trying to figure out why. What's turning on the genes during puberty? And what we found is that increases in estradiol apparently are activating genetic risk for eating disorders."

Estradiol is the predominant form of estrogen in females and is responsible for the growth of reproductive organs and also influences other organs including bones.

Klump noted that researchers don't yet know which genes are being switched on by estradiol. Further, she said a larger study is needed to confirm the results of the MSU-led research.

But knowing that estradiol likely plays a role in the development of eating disorders could ultimately open the window to new treatments, said Klump, past president of the Academy of Eating Disorders.

In addition, she said, prevention efforts could be geared toward those girls who not only are in high-risk environmental contexts (such as weight-focused sports), but also those with genetic risks such as a family history of eating disorders.

The study examined the estradiol levels of nearly 200 sets of female twins, ages 10-15, from the MSU Twin Registry, which includes more than 5,000 pairs of twins in Michigan. Klump runs the registry with S. Alexandra Burt, assistant professor of psychology.

Co-authoring the study were Burt, Cheryl Sisk at MSU and Pamela Keel at Florida State University.

NewsPsychology (May 26, 2010) — A team of American psychologists and neuroscientists have found that adult brain volume, which can be reduced by Anorexia Nervosa, can be regained. The research, published in the International Journal of Eating Disorders, revealed that through specialist treatment patients with this eating disorder can reverse this symptom and regain grey matter volume.

Anorexia Nervosa (AN) is a serious psychiatric eating disorder of excessive weight loss caused by relentless dieting. The starvation that results from this illness affects physiological systems throughout the body, including the brain, but until now it has been unclear if and when brain volume reduction can be reversed through specialist treatment.

“Anorexia Nervosa wreaks havoc on many different parts of the body, including the brain,” said team leader Christina Roberto, MS, MPhil from Yale University. “In our study we measured brain volume deficits among underweight patients with the illness to evaluate if the decline is reversible thought short-term weight restoration.”

The team, based at the Columbia University Center for Eating Disorders used magnetic resonance imaging (MRI) to take pictures of the brains of 32 adult female inpatients with Anorexia Nervosa and 21 healthy women without any psychiatric illnesses.

The scans indicated that when the women with Anorexia Nervosa were in a state of starvation they had less grey matter brain volume compared to the healthy women. Those who had the illness the longest had the greatest reductions in brain volume when underweight.

“The good news is that when women with Anorexia Nervosa received treatment at a specialized eating disorders inpatient unit at Columbia University which helped them gain to a normal weight, the deficits in brain volume began to reverse over the course of only several weeks of weight gain,” said Roberto. “This suggests that the reductions in brain matter volume that results from starvation can be reversed with appropriate treatment aimed at weight restoration.”

The team’s results reveal that underweight adult patients with AN have reduced brain volumes that increase with short-term weight restoration, however important questions still remain surrounding the link between brain volume reduction and anorexia.

“There is still plenty of research to be done. We do not yet have a good sense of the clinical implications of these reductions in brain volume,” concluded Mrs. Roberto. “It is unclear how brain volume deficits impact functioning, which specific regions of the brain are most affected or if these deficits are linked to how patients respond to treatment.”

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Story Source:

The above story is reprinted (with editorial adaptations by newsPsychology staff) from materials provided by Wiley-Blackwell, via EurekAlert!, a service of AAAS.

Journal Reference:

1. Christina A. Roberto, Laurel E. S. Mayer, Adam M. Brickman, Anna Barnes, Jordan Muraskin, Lok-Kin Yeung, Jason Steffener, Melissa Sy, Joy Hirsch, Yaakov Stern, B. Timothy Walsh. Brain tissue volume changes following weight gain in adults with anorexia nervosa. International Journal of Eating Disorders, 2010; DOI: 10.1002/eat.20840

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of NewsPsychology or its staff.

NewsPsychology (May 20, 2010) — Imagine stuffing yourself with a day’s worth of food in two hours or less. Imagine feeling disgusted, depressed and guilty once you finally stop. Then imagine doing it again, repeatedly and uncontrollably, once a week or more for months on end.

You have just imagined yourself with binge eating disorder (BED), a psychiatric condition similar to other eating disorders like bulimia, minus the countervailing purging behaviour, and compulsive overeating, but without the constant fantasizing about food. Some BED sufferers, in fact, have very negative associations with food. Moreover, until now, researchers knew little about the underlying causes of BED.

David M. Dunkley, a psychiatric researcher and clinical psychologist at the Jewish General Hospital (JGH) in Montreal, and his colleagues studied a group of 170 BED sufferers and discovered that the severity of the condition — reflected by greater body dissatisfaction and depressive symptoms — appears to be linked to very specific histories of childhood sexual or emotional abuse, which in turn lead to self-criticism.

Their results were published recently in the International Journal of Eating Disorders.

“Childhood sexual abuse or emotional abuse were associated with greater body dissatisfaction in BED, whereas physical abuse or physical or emotional neglect were not,” explained Dunkley, a project director at the Lady Davis Institute for Medical Research at the JGH and Assistant Professor of Psychiatry at McGill University.

According to the Public Health Agency of Canada, an estimated two percent of the adult population in North America suffers from binge eating disorder, approximately 450,000 Canadians and nearly four million Americans. It is twice as common among women as among men.

“I definitely suggest that therapists focus on self-criticism in cases of suspected childhood maltreatment in BED,” continued Dunkley. “We did look at alternative theories, like childhood emotional abuse leading to depression which leads to body dissatisfaction and self-criticism. But it doesn’t seem to work that way. Self-criticism is the mediator. Without it, it doesn’t seem to progress to greater body dissatisfaction in BED.”

Email or share this story:

Story Source:

The above story is reprinted (with editorial adaptations by newsPsychology staff) from materials provided by Jewish General Hospital.

Journal Reference:

1. David M. Dunkley, Robin M. Masheb, Carlos M. Grilo. Childhood maltreatment, depressive symptoms, and body dissatisfaction in patients with binge eating disorder: The mediating role of self-criticism. International Journal of Eating Disorders, 2010; DOI: 10.1002/eat.20796

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of NewsPsychology or its staff.

Pathological gambling, compulsive shopping, binge eating and other impulse control disorders appear to be more common among individuals taking dopamine agonist medications for Parkinson's disease, according to a report in the May issue of Archives of Neurology, one of the JAMA/Archives journals.

These behaviors have been reported previously in patients with Parkinson's disease, according to background information in the article. Preliminary estimates of impulse control disorders in this population range from 1.7 percent to 6.1 percent for gambling, 2 percent to 4 percent for compulsive sexual behavior and 0.4 percent to 3 percent for compulsive buying.

Daniel Weintraub, M.D., of the University of Pennsylvania, Philadelphia, and Philadelphia Veterans Affairs Medical Center, and colleagues studied 3,090 patients being treated for Parkinson's disease at 46 movement disorder centers in the United States and Canada.

Impulse control disorders were identified in 13.6 percent of patients, including gambling in 5 percent, compulsive sexual behavior in 3.5 percent, compulsive buying in 5.7 percent, binge-eating disorder in 4.3 percent and two or more of those in 3.9 percent. The disorders were more common in individuals taking dopamine agonists compared with patients not taking dopamine agonists (17.1 percent vs. 6.9 percent).

Additional variables that were associated with these disorders included the use of levodopa, another therapy for Parkinson's disease; living in the United States; being younger or unmarried; smoking cigarettes; and having a family history of gambling problems.

"Dopamine agonist treatment in Parkinson's disease is associated with 2- to 3.5-fold increased odds of having an impulse control disorder," the authors write. "This association represents a drug class relationship across impulse control disorders. The association of other demographic and clinical variables with impulse control disorders suggests a complex relationship that requires additional investigation to optimize prevention and treatment strategies."

Dopamine agonists are increasingly used to treat other conditions, including restless legs syndrome and fibromyalgia, the authors note. "Larger epidemiologic studies in these other populations are needed to examine the possible relationships between dopamine agonist treatment, other clinical features and impulse control disorders," they conclude.

Journal Reference:

1. Daniel Weintraub; Juergen Koester; Marc N. Potenza; Andrew D. Siderowf; Mark Stacy; Valerie Voon; Jacqueline Whetteckey; Glen R. Wunderlich; Anthony E. Lang. Impulse Control Disorders in Parkinson Disease: A Cross-Sectional Study of 3090 Patients. Arch Neurol, 2010; 67 (5): 589-595 

— How many times have you, after a particularly hard day, reached for some chocolate or ice cream? It's common for many people, but for those trying to lose weight, it can be detrimental to their long term success, and most weight-loss programs never even address it.

They focus on choosing healthier foods and exercising more, but they never answer a key question: how can people who have eaten to cope with emotions change their eating habits, when they haven't learned other ways of coping with emotions?

Researchers at Temple's Center for Obesity Research are trying to figure out the answer as part of a new, NIH-funded weight loss study. The new treatment incorporates skills that directly address the emotional eating, and essentially adds those skills to a state-of-the art behavioral weight loss treatment.

"The problem that we're trying to address is that the success rates for long-term weight loss are not as good as we would like them to be," said Edie Goldbacher, a postdoctoral fellow at CORE. "Emotional eating may be one reason why people don't do as well in behavioral weight loss groups, because these groups don't address emotional eating or any of its contributing factors."

The study has already had one wave of participants come through, and many participants have seen some success in the short term, but have also learned the skills to help them achieve long term success.

Janet Williams, part of that first cohort, said she lost about 17 pounds over 22 weeks, and still uses some of the techniques she learned in the study to help maintain her weight, which has not fluctuated.

"The program doesn't just help you identify when you eat," said Williams. "It helps you recognize triggers that make you eat, to help you break that cycle of reaching for food every time you feel bored, or frustrated, or sad."

Williams said that the program teaches various techniques to help break that cycle, such as the "conveyor belt," in which participants, when overcome with a specific emotion, can recognize it and take a step back, before reaching for chips or cookies, and put those feelings on their mental "conveyor belt" and watch them go away.

"I still use the skills I learned in the study," she said. "I've learned to say, 'I will not allow this emotional episode to control my eating habits.'"