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Rothschild, Rachel; Quitkin, H. Matthew; Quitkin, Frederic M.; Stewart, Jonathan W.; Ocepek‐Welikson, Katja; McGrath, Patrick J.; Tricamo, Elaine
doi: 10.1002/1098-108X(199401)15:1<1::AID-EAT2260150102>3.0.CO;2-Epmid: 8124322
Although antidepressants have been found to be superior to placebo in 12 of 14 studies, the relationship between improvement in the depressive diathesis and bulimia is unclear. In this study, the efficacy of placebo, imipramine, and phenelzine is examined in patients comor‐bid for atypical depression and bulimia. Greater improvement was observed for both depressive and bulimic symptoms with phenelzine than with either imipramine or placebo. Consistent with its poor ant/depressant effects in atypical depression, imipramine seemed to have minimal efficacy for the bulimic symptoms of atypical depressives. These data suggest that the presence of bulimia does not alter the treatment response of atypically depressed patients. Furthermore, the data may suggest a link between depression and bulimia in atypical depressives. Demonstrating a statistical difference with a small sample suggests the effect size is robust, however conclusions are limited by a small sample size. © 1994 by John Wiley & Sons, Inc.
Levine, Michael P.; Smolak, Linda; Moodey, Anne F.; Shuman, Melissa D.; Hessen, Laura D.
doi: 10.1002/1098-108X(199401)15:1<11::AID-EAT2260150103>3.0.CO;2-Qpmid: 8124323
Three predictions based on Levine and Smolak's (1992) developmental model of dieting and eating disturbances were tested: (1) Changes in pubertal status and/or dating status increase the probability of no pathological dieting in middle school girls; (2) concurrent change in pubertal status, dating status, and academic stress increases the probability of sub clinical eating disturbances in girls with a slender body ideal; and (3) the co‐occurrence of modeling cues and direct messages from peers and/or family about the importance of weight, shape, and dieting increases the probability of these effects. Three hundred eighty‐two girls were asked about menarcheal status, dating status, and academic stress, as well as attitudes about shape, eating behavior, and perceptions of peer and family pressures for slenderness. Results confirmed several of the predictions, suggesting that the interaction among cumulative developmental changes in early adolescence, adherence to a slender body ideal, and sociocultural pressures for thinness may be useful in distinguishing middle schoolers at risk for subclinical eating disturbances from both girls who do not diet and girls whose dieting is or will be “normative.” © 1994 by John Wiley & Sons, Inc.
Beumont, Peter J. V.; Arthur, Brenden; Russell, Janice D.; Touyz, Stephen W.
doi: 10.1002/1098-108X(199401)15:1<21::AID-EAT2260150104>3.0.CO;2-Kpmid: 8124324
A relationship between starvation and hyperactivity has been observed in animal models, in experiments with human subjects, and in dieting disorder patients. Since the earliest descriptions of anorexia nervosa, excessive physical activity has figured prominently as a symptom of the illness, yet little attention has been directed towards this phenomenon. The aims of this paper are to review the published literature, to report our experience of the role of physical over activity in the clinical presentation of dieting disorders, to discuss its implications for treatment, and to propose a supervised exercise program by which over activity may be addressed specifically in the treatment of these patients. © 1994 by John Wiley & Sons, Inc.
doi: 10.1002/1098-108X(199401)15:1<37::AID-EAT2260150105>3.0.CO;2-8pmid: 8124325
Researchers have been unable to discern the relationship between energy expenditure and obesity because there has been no reliable, unobtrusive method to capture daily activity. The Caltrac Personal Activity Computer® (Caltrac) is a small, portable acceler‐ometer that translates motion into activity counts when worn by human subjects. It has shown high test‐retest reliability during laboratory trials and has demonstrated a strong relationship to several measures of energy expenditure in some laboratory tests. In order to correlate activity with amount of body fat, 39 university women (mean age = 79.75 years, mean weight = 135 Ib, SD = 27.77, range = 100–220 Ib) wore Caltracs for either 3 (n = 39) or 6(n = 26) consecutive days. Pearson product‐moment correlation coefficients showed a moderate negative relationship between Caltrac counts and body mass index (BMI) (r = − .47, p ⩽ .01) for Days 4–6 in the subjects who wore the Caltrac for 6 days, but there was no correlation between Caltrac counts and any measures of body fat for the first 3‐day period. © 1994 by John Wiley & Sons, Inc.
De Zwaan, Martina; Mitchell, James E.; Seim, Harold C.; Specker, Sheila M.; Pyle, Richard L.; Raymond, Nancy C.; Crosby, Ross B.
doi: 10.1002/1098-108X(199401)15:1<43::AID-EAT2260150106>3.0.CO;2-6pmid: 8124326
One hundred obese women with a mean age of 39.2 years, and a mean body mass index (BMI) of 35.9 kg/m2 were evaluated before entering a treatment study for weight reduction. According to the results of a structured interview, subjects were divided into four groups: (?) no overeating episodes, (2) episodic overeating episodes without the feeling of loss of control, (3) overeating plus the sense of loss of control (binge eating), and (4) full diagnostic criteria for binge eating disorder (BED). One‐way analyses of variance (ANOVAs) revealed significant positive associations between binge eating and eating/weight‐related characteristics such as a history of frequent weight fluctuations, the amount of time spent dieting, drive for thinness, and a tendency for disinheriting of eating. Furthermore, subjects exhibited more feelings of ineffectiveness, stronger perfectionist attitudes, more impulsivity, less self‐esteem, and less interceptive awareness the more problems with binge eating they reported. The results support the idea that binge eaters might be a distinct subgroup among the obese population, and corroborate the utility of a diagnosis of BED in identifying the most disturbed obese subjects with regard to the variables tested. © 1994 by John Wiley & Sons, Inc.
Telch, Christy F.; Agras, W. Stewart
doi: 10.1002/1098-108X(199401)15:1<53::AID-EAT2260150107>3.0.CO;2-0pmid: 8124327
Obese female subjects with binge eating disorder BED; (N = 107) completed the Beck Depression Inventory, Symptom Checklist‐90, Inventory of Interpersonal Problems, and Rosenberg Self‐Esteem Scale. Subjects were divided into moderate or severe binger on the basis of scores on the Binge Eating Scale, and grouped into moderately or severely obese by performing a median split on their weights. Spearman correlational analyses were performed to determine the relationship between psychopathol‐ogy and obesity and psychopathology and binge eating. Analyses of variance (ANO‐VAs) were then performed using scores on the psychological measures with subjects grouped both by severity of obesity and severity of binge eating. The results indicated that in our sample, obesity and scores on the measures of psychiatric symptomatology were unrelated. However, a significant positive relationship was found between binge eating severity and degree of psychiatric symptomatology. We suggest that binge eating may account for the observed relationship between obesity and psychopathology reported in previous studies. We discuss the importance of assessing BED when conducting research with obese individuals. © 1994 by John Wiley & Sons, Inc.
Pirke, Karl M.; Kellner, Michael B.; Frieß, Elisabeth; Krieg, Jürgen‐C.; Fichter, Manfred M.
doi: 10.1002/1098-108X(199401)15:1<63::AID-EAT2260150108>3.0.CO;2-Vpmid: 8124328
The effect of a fat and protein rich test meal of 800 kcal on subjective satiety ratings and on plasma cholecystokinin (CCK) 8–5 was studied in 18 acutely ill patients with anorexia nervosa, 11 former anorectic patients, who were weight recovered for at least 4 years, and in 25 healthy young women. Eleven normal weight patients with bulimia nervosa were studied in the same experiment. Satiety ratings were significantly elevated in acutely ill anorectic and bulimic patients. CCK 8–5 values were significantly stimulated by the test meal in all groups except from the bulimic group. Anorectic patients and weight recovered anorectics had normal values before and after the test meal. Bulimic patients had significantly lower values. These data suggest that CCK 8‐S is not involved in the regulation of short‐term satiety in anorexia and bulimia nervosa. © 1994 by John Wiley & Sons, Inc.
doi: 10.1002/1098-108X(199401)15:1<71::AID-EAT2260150109>3.0.CO;2-Rpmid: 8124329
An increased rate of pathological eating attitudes has been reported among the people under acculturative stresses. We therefore carried out a prospective study of eating patterns in a cohort of 144 Japanese adolescents who spent 1 year with a host family in various countries of the world. The subjects showed a statistically significant gain in standardized body weight. Although the students did not report greater prevalence of abnormal eating attitudes under acculturative stresses than before, a substantial minority of them manifested maladap‐tive eating patterns. Among the psychosocial variables measured before departure, personality traits of neuroticism and introversion correlated with high drive for thinness during the stay; parental overprotection, lack of interoceptive awareness, and interpersonal distrust predicted bulimic behaviors. The findings are discussed from a transcultural point of view. © 1994 by John Wiley & Sons, Inc.
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