Oliva Rosella Euro Weight Loss-2015 Frankfurt, Germany August 18 – 20, 2015.
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Transcript of Oliva Rosella Euro Weight Loss-2015 Frankfurt, Germany August 18 – 20, 2015.
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Oliva Rosella
Euro Weight Loss-2015Frankfurt, Germany
August 18 – 20, 2015
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OBESITYTHE RELATIONSHIP BETWEEN BINGE EATING DISORDER AND FOOD ADDICTION
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ACKNOWLEDGEMENTS
Dr. Monica Baiano – Centre for the treatment of Eating Disorders of Portogruaro (VE), Italy
Prof. Nazario Melchionda – Past President of the Italian Society for the Study of Eating Disorders (SIS.DCA)
Outpatient Service for the treatment of Eating Disorders Mestre (VE), Italy
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BINGE EATING DISORDER (BED)
Episodes of binge-eating (at least once a week for 3 months)
sense of lack of control
marked distress
Sense of guilt
NO compensatory behaviors.
DSM 5 (APA, 2013)
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“Some individuals with disorders described in this chapter report EATING-RELATED SYMPTOMS RESEMBLING THOSE TYPICALLY ENDORSED BY INDIVIDUALS WITH SUBSTANCE-USE DISORDERS, such as strong craving and patterns of compulsive use (…)” (DSM-5, p 329)
Similarities between the behavioral indicators of addiction and Binge Eating Disorder (Gearhardt et al, 2011)
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WHAT IS AN ADDICTION?
A chronic relapsing disorder characterised by:
Compulsion to seek and take the drug Loss of control in limiting intake Emergence of a negative emotional state
(dysphoria, anxiety, irritability)
(George Koob, 1947 – present)
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BED & ADDICTION
Behavioral and biological overlaps between eating and addictive disorders
Loss of control
Unsuccessful efforts to cut down
A great deal of time spent thinking about the substance or engaging in the behavior
Continuing the behavior despite related consequences
Changes in social, occupational or recreational activities
Withdrawal and Tolerance symptoms
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HYPOTHESIS
1) Food addiction as a causal factor for chronic overeating
2) Food addiction as a valid phenotype of obesity
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BED/FOOD ADDICTION/OBESITY
OBESITY
BED
FA
OBESITY
FABED
OBESITY
BED
FA
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OVERCOMING HETEROGENEOUS DEFINITIONS
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YALE FOOD ADDICTION SCALE (YFAS)
1. Substance taken in larger amount and for longer period than intended.
2. Persistent desire or repeated unsuccessful attempt to quit.
3. Much time/activity to obtain, use, recover,
4. Important social, occupational, or recreation activities given up or reduced.
5. Use continues despite knowledge of adverse consequences (e.g., failure to fulfill role obligation, use when physically hazardous).
6. Tolerance (marked increase in amount; marked decrease in effect).
7. Characteristic withdrawal symptoms; substance taken to relieve withdrawal.
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Rossella Oliva - Euro Weight Loss 2015
81 obese patients with a diagnosis of BED
- 57% BED and FA- 43% BED
1. BED and FA are related but do not totally overlap
2. FA is associated with higher levels of depression, negative affect and eating disorders psychopathology
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THE RESEARCH
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OBJECTIVE
Is food addiction a clear and distinct phenotype compared to Binge Eating Disorder?
Exploration of the presence of food addiction-like eating behaviors
in a sample of obese treatment-seeking patients.
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PARTICIPANTS
Ninety-four obese treatment-seeking patients
N AGE (M ± DS) BMI (M ± DS)
Men 21 46,3 ± 12,8 35,7 ± 6,5
Women 73 39 ± 13,5 31,6 ± 8,3
Total 94 40,4 ± 13,8 32,6 ± 8,1
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MATERIALS & METHODS
Yale Food Addiction Scale, YFAS (Gearhardt et al, 2009)
Binge Eating Scale, BES (Gormally et al, 1982)
Three Factor Eating Questionnaire, TFEQ (Stunkard et al, 1985)
Beck Depression Inventory, BDI (Beck et al, 1996)
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MATERIALS & METHODS
Statistical Package for Social Science – SPSS (Levesque et al, 2007)
Descriptive statistics
Correlation between the scoring of the YFAS and:
1. Beck Depression Inventory (BDI)
2. Binge Eating Scale (BES)
3. Three Factor Questionnaire (TFEQ)
Observed Frequencies (YFAS and BES)
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RESULTS
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CORRELATIONS
YFAS Symptom
BES 0.68*(,000)
BDI 0,48* (,000)
TFEQ Disinhibition 0,5* (,000)
TFEQ Hunger 0,78* (,000)
TFEQ Restriction -,09 NS
BMI ,01 NS
* Correlation is significant at the 0,01 level (2-tailed)
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OBSERVED FREQUENCIES
YFAS (+) YFAS (-)
BES (+) 35 (37%) 8 (9%)
BES (-) 18 (19%) 33 (35%)
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0 5 10 15 20 25 30 35 40 45 500
1
2
3
4
5
6
7
8
BES
YFA
S
y= 0,1273x + 1,0968R2= 0,4344*
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CONCLUSIONS
Binge eating disorder (bed) and ‘food addiction’ are related but do not totally overlap.
Individuals with clinically relevant disordered eating that would not meet BED criteria, but could possibly result in obesity, may be captured under an addiction framework.
OBESITY
FA BED
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FUTURE DIRECTIONS
“Examining the neural correlates of the different endophenotypes may enrich our understanding of the biobehavioral mechanisms of appetite and addiction”
(Carnell et al, 2013)
Important clinical implication for the optimization of the treatment and the empirical exploration of BED – FA – OBESITY
Incorporation of eating and addiction assessments like the BES or the YFAS into studies of Obesity and Eating disorders and clinical practice could have important implications.
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THANK YOU FOR YOUR ATTENTION
Rossella Oliva
[email protected]+39 340 530 44 65
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BINGE EATING
GUILT
PLEASURE
MOOD DYSREGULATION
IMPULSIVITYBMI
LACK OF CONTROL
RESTRICTION
FOOD ADDICTION
BINGE EATING DISORDER
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Euro Weight Loss – 2016
website: http://weightloss.global-summit.com/europe/
Meet the eminent gathering once again at
Euro Weight Loss-2016Vienna, Austria
September 19-21, 2016