Binge-eating Disorders

Low body mass index (BMI<18/18.5) is utilized as a mandated cutoff for professional fashion model employment, based on assumptions that low BMI indicates eating disorder pathology. No previous studies have examined the association between experimenter-measured BMI and eating disorder symptomatology in professional fashion models. We measured BMI and Eating Disorder Examination Questionnaire (EDE-Q) responses in United Kingdom (UK) professional fashion models, and nonmodels. Characteristics were compared using robust standardized mean difference (rSMD) obtained via probability of superiority. Associations between BMI and eating disorder symptomatology were examined using robust regression, controlling for age. Models exhibited lower BMI but higher fat-percentage and muscle mass. On the EDE-Q, models had higher Restraint, Global, Eating, and Weight Concerns, and similar Shape Concern scores compared to nonmodels. BMI was positively associated with eating disorder symptoms in both groups, and all but one of the eight models with clinically significant EDE-Q level had ≥18.5 measured BMI. Lower BMI was not indicative of worse eating disorder symptomatology in models or nonmodels. Thus, using a low BMI cutoff (<18.5) may not be an appropriate single index of health for detecting elevated eating disorder symptoms in models. Different policies to protect models’ health should be considered.

Uzmanlar, klinisyenler ve araştırmacılar, yeme bozukluklarının duygusal düzensizliklerden kaynaklandığı vakalarda Diyalektik Davranış Terapisinin etkin olacağı konusunda hemfikirdi. Alanda yapılan pek çok adaptasyon çalışması olmasına rağmen Debra Safer, Christy Telch ve Eunice Chen bunu deneysel bazda yapan ilk kişilerdir. Standart diyalektik davranış terapisinin, tıkanırcasına yeme bozukluğu ve blumia nervoza semptomlarını tedavi etme yollarının yapılandırılmış bir özetini sunan bu kitap ile alandaki ihtiyaca cevap vermişlerdir. Bu alanda çalışan klinik psikologların ve danışmanların mutlaka okuması gereken önemli bir kaynak olmakla birlikte bu alanda okuyan öğrenciler için de farklı bir bakış açısı kazandırmaktadır.
Dokuz bölümden oluşan bu kitapta tedavi kapsamlı olarak ele alınmıştır. Genel çerçevede, olumsuz duygularla başa çıkmanın daha uyumsal yollarını öğreten becerilerin kazanımı ile tıkanırcasına yeme ve boşaltmayı durdurma hedefine ulaşma yolu adım adım çizilmiştir. Blumia nervoza ve tıkanırcasına yeme bozukluğuna sahip insanların karılaştığı sorunlar ve mevcut tedavi yöntemleri ele alınarak okuyucuya genel bir bakış açısı kazandırılır. Standart terapinin detaylı bir şekilde tanıtımından sonra bunun adaptasyonunun neden gerekli olduğu, adapte etmenin mantığı mevcut kanıtlar ile sunulur. Daha sonra, tedavi öncesi ve başlangıç oturumlarından tedaviyi sonlandırmaya kadar olan süreç aşama aşama ele alınır. Nüksetmeyi önleme kısmına değinilir. Son olarak kapsamlı vaka örnekleri ile anlatılanların sağlam temeller üzerine oturması sağlanır.
Amacına uygun şekilde düzenlen bu kitap, diyalektik davranış terapisi adapte edilirken belirli sınırlar çizmek yerine okuyucuya geliştirilebilir bir zemin hazırlar. Bu yönüyle tedaviyi uygulamaya ve geliştirmeye teşvik eder. Açıklayıcı vaka örnekleri ve kanıtlar ile tedaviyi tüm ayrıntılarıyla sunarak farklı alanlardan okuyuculara hitap eden bu titiz çalışma özellikle alandaki uzmanlara klinik psikologlara, danışmanlara ve araştırmacılar için bir rehber niteliğinde olacak niteliktedir.

Objectives This study aims to assess the prevalence of health problems (eg, insomnia, binge-eating, substance use and ill health) among UK doctors and to investigate whether occupational distress increases the risk of health problems. Design This study reports the analysis of data collected at the baseline stage of a randomised controlled trial (protocol #NCT02838290). setting Doctors were invited through medical Royal Colleges, the British Medical Association's research panel and a random selection of NHS trusts across various UK regions. Participants 417 UK doctors with an equivalent split of gender (48% males) and seniority (49% consultants). Main outcomes and measures Outcomes were sleep problems (eg, insomnia), alcohol/drug use (eg, binge-drinking), ill health (eg, backache) and binge-eating (eg, uncontrollable eating). Predictor variables were occupational distress (psychiatric morbidity, burnout, job effort, work-life imbalance, coping with stress through self-blame or substances) and work factors (workplace and years practising medicine). results 44% of doctors binge-drank and 5% met the criteria for alcohol dependence; 24%-29% experienced negative emotions after overeating and 8% had a binge-eating disorder; 20%-61% had some type of sleep problem and 12% had severe/moderate insomnia; 69% had fatigue and 19%-29% experienced other types of ill health problems. The results show that occupational distress and job factors increase the odds of doctors using substances, having sleep problems, presenting with frequent symptoms of ill health and binge-eating. For example, burnout increased the risk of all types of sleep problems, eg, difficulty falling/staying asleep, insomnia (OR ≥1.344; p≤0.036). Even taking into consideration whether or not a doctor works in a hospital, the risk of health problems still rises when doctors have signs of occupational distress. Conclusion Early recognition of occupational distress can prevent health problems among UK doctors that can reduce the quality of patient care because of sickness-related absence.

A obesidade tem sido considerada uma das doenças mais sérias e de mais rápida disseminação em países desenvolvidos . Um terço da população adulta nos Estados Unidos está obesa , e no Brasil, onde até recentemente esta condição não era considerada epidêmica, 17,5% da população adulta já é obesa e cerca de 50 % está acima do peso, segundo o Ministério da Saúde. De forma geral o tratamento da obesidade mórbida costuma ser frustrante e atualmente a cirurgia bariátrica é considerada o único tratamento efetivo e duradouro para estes casos.
Uma quantidade substancial de transtornos psiquiátricos ou perfis psicológicos anormais acomete os candidatos à cirurgia bariátrica, aumentando o risco de desfechos pós-operatórios desfavoráveis, que variam desde a perda de peso abaixo da esperada ou o reganho precoce de peso, até a piora da condição psiquiátrica ou psicológica de base.
Embora avaliações psiquiátricas e psicológicas já façam parte da rotina da maioria dos serviços de cirurgia bariátrica, elas se concentram mais na verificação da capacidade do paciente tomar uma decisão responsável e compreender/seguir as orientações médicas (o “laudo tradicional”) do que nas múltiplas interações entre psicopatologia e a evolução do tratamento cirúrgico da obesidade, um terreno no qual há pouco ou nenhum consenso entre os especialistas. Da mesma forma, os critérios psiquiátricos para a contraindicação do tratamento cirúrgico para a obesidade costumam incluir casos graves de alcoolismo ou uso de drogas ilícitas, sintomas ativos de esquizofrenia e retardo mental severo, mas as condutas envolvendo a grande maioria dos candidatos à cirurgia com alguma comorbidade psiquiátrica, que abrange portadores de transtornos do humor, transtornos ansiosos, transtornos do comportamento alimentar e história de ideação e/ou tentativa de suicídio, para citar apenas alguns, são muito variáveis. 
O presente texto tem por objetivo revisar e discutir as relações entre psicopatologia e tratamento cirúrgico da obesidade e se concentra em questões como até que ponto variáveis psicológicas e psiquiátricas influenciam a perda ou o reganho de peso após a cirurgia bariátrica, quais as chances da cirurgia bariátrica piorar ou melhorar condições psiquiátricas pré-existentes ou deflagrar sintomas psiquiátricos em quem nunca os teve e quais seriam as contraindicações psiquiátricas relativas e absolutas para a cirurgia bariátrica.

Данная статья посвящена раскрытию психологического взгляда на формирование пищевых нарушений. В статье представлены теории пищевого поведения, классификация нарушений пищевого поведения, а также психологические особенности людей с нарушениями пищевого поведения. Представлен теоретический анализ диагностических критериев и методов исследования пищевого поведения.

In his quest for awakening, according to the traditional account the Buddha tried and discarded various ancient Indian practices as being not in themselves conducive to awakening. Nevertheless, closer inspection shows that key elements of these practices became part of the Buddhist path, a transformation that involves mindfulness in one way or another. In this way, fasting transforms into mindful eating, breath control into mindfulness of breathing, and a reformulation of an aspiration for annihilation of the self, apparently held by ancient Indian cultivators of the meditative sphere of neither-perception-nor-non-perception, comes to be conjoined to the cultivation of mindfulness of the body. These transformations shed light on the importance and adaptability of mindfulness in early Buddhist soteriology.

Grazing, or the uncontrolled, repetitive eating of small amounts of food is being increasingly recognised as an important eating behaviour associated with obesity. In spite of the need for a better understanding of this eating behaviour for improved obesity treatment, currently there is no empirically validated self-report measure to  assess grazing. Therefore, to contribute to a better understanding of this relatively understudied eating pattern, a new self-report questionnaire of grazing was developed in this study. Questionnaire items were designed to reflect previous empirical descriptions of grazing. A group of 248 university students completed the Grazing Questionnaire, other measures of eating related behaviours and cognitions, and negative emotion. Sixty-two participants completed the Grazing Questionnaire a second time to calculate its temporal stability. Exploratory factor analysis revealed a clear two-factor solution for the questionnaire, reflecting repetitive eating behaviour and a perception of loss of control. Scores on the Grazing Questionnaire were positively associated with other measures of disordered eating, especially with binge eating. Initial psychometric properties of the new questionnaire are promising. Future research is now needed to examine the prevalence of this eating behaviour in more diverse populations, including those with binge eating disorder and obesity.

The eating disorders have been reviewed based on state-of-art of contemporary psychology, medicine and nutrition science, with a special emphasis put on different symptoms and forms, origins and testing methods. Among promoting eating disorders, bulimia nervosa, binge eating disorder, night eating disorder, sleep-related eating disorder are among officially approved and investigated. Among disorders resulting from lack of acceptance of own appearance, anorexia nervosa and bigorexia nervosa are the most serious improper ones. Disorders arising from health care include orthorexia nervosa and recently pregorexia. Different origins of eating disorders are considered, divided into three groups: social, psychological and pathological. The desire to possess a slim shapely silhouette and young appearance, usually under pressure of a social group, may result in disorders such as anorexia nervosa, pregorexia, ageorexia, and bigorexia nervosa. On the other hand, the focusing on eating mainly the biological pure food, being a purely psychological and individual problem, may be a source of orthorexia nervosa. Majority of disorders have a psychological background constituting the escape and an answer to everyday life problems difficult to overcome. Recently, pathology is often considered as an additional and important determinant, which may cause or enhance the appearance of binge eating or night eating disorder. The eating disorders, if not subject to proper therapy and advising, can tend to incline and develop. The further research in order to properly recognise the eating disorders, and find their roots, is necessary at a strict cooperation of psychologists, physicians and nutritionists or dietetics.

Notre travail de thèse porte sur l’analyse des rapports entre le normal et le pathologique à la lumière d’un trouble du comportement alimentaire : l’anorexie mentale. Nous cherchons conjointement à élaborer un modèle d’intelligibilité de l’anorexie mentale, et à déterminer ce que ce modèle nous enseigne du rapport normal et sain au corps. La normalité relève-t-elle d’une différence de nature ou de degré avec l’état psychopathologique ? Le critère de la normalité peut-il être saisi dans l’expérience antérieure au développement du trouble chez le sujet anorexique ? Peut-il être recherché dans une norme sociale extérieure au sujet ? Nous avançons que le critère de la normalité ne peut être découvert que de manière immanente, au cœur de l’expérience pathologique et de celle de la rémission. C’est donc à la conceptualisation de ces dernières que nous avons dû nous consacrer. 

Notre travail comprend la conceptualisation de l’anorexie mentale comme d’une forme de production aliénée de la subjectivité dans le contexte sociologique déterminé de l’individualisme moderne. Nous nous appuyons premièrement sur les travaux de Dorothée Legrand, qui, à partir de la notion phénoménologique de « conscience de soi corporelle », voient dans l’anorexie mentale une rupture des liens typiquement complémentaires entre le corps-comme-sujet (le corps vécu depuis une perspective interne) et le corps-comme-objet (le corps visé, perçu extérieurement, mais aussi en tant qu’il partage une matérialité commune avec d’autres objets). Le sujet anorexique est celui qui, d’après cette conceptualité, cherche à transformer, de manière contrôlée, son corps-objet, afin d’en faire une matérialisation ou expression de sa subjectivité. Paradoxalement, l’amaigrissement et même la « négation » du corps-objet sont « auto-constitutives » en ce sens qu’elles contribuent à exprimer et consolider la subjectivité. Le sujet anorexique s’affirme à travers la modification contrôlée de son corps-objet : il fait de la dimension objective de son corps une sorte de miroir de sa subjectivité. Il peut alors, à partir de cette extériorisation maîtrisée, rechercher la validation de sa condition de sujet par d’autres sujets.

C’est parce que le vécu du corps-sujet est trop faible chez la personne anorexique, et celui du corps-objet hypertrophié, qu’elle tente de contrôler le corps-objet pour en faire un support externe doué d’une capacité expressive du soi et par suite une attestation de sa propre existence. Nous pouvons alors comprendre l’anorexie mentale dans une perspective hégélienne : le sujet anorexique « travaille » son corps pour y apposer le « sceau » de son intériorité, les déterminations de sa conscience. Ce faisant, il arrache à la matérialité brute du corps son caractère d’étrangeté et peut s’y reconnaître ; de même, il peut, à l’issue de son travail, obtenir des autres sujets une reconnaissance. Nous pensons cependant que ce modèle n’épuise pas la compréhension de l’anorexie mentale.

Selon nous, l’anorexie mentale relève plutôt d’une stratégie à composante addictive par laquelle, tout à la fois, le sujet tente de devenir un individu performant sur la scène sociale, et échappe à une réelle expression de sa subjectivité. Nous pensons que le « soi » du sujet anorexique est une notion opaque pour lui, dont les contours sont mal définis, et qu’il ne peut par suite extérioriser les composantes de ce « soi » dans le corps-objet. Comment le pourrait-il, en effet, s’il ne se connaît pas réellement lui-même ? Nous avançons ainsi que l’anorexie mentale procède d’une angoisse fondamentale : celle de l’indétermination de la subjectivité, notamment en raison de la prévalence de l’alexithymie dans la personnalité. Or, cette indétermination subjective interne coexiste, dans les sociétés occidentales modernes, avec l’injonction, intensément ressentie par les sujets anorexiques perfectionnistes, d’être « quelqu’un » – c’est-à-dire de devenir un individu accompli et d’obtenir à ce titre une validation sociale. Enfin, comme le mettent en évidence les travaux de Hilde Bruch, les personnes anorexiques souffrent d’un « sentiment d’inefficacité » intrinsèque, qui les persuade qu’elles ne sont pas réellement capables d’atteindre l’autonomie et d’avoir une incidence positive sur le monde extérieur par leurs efforts. L’amaigrissement joue alors un triple rôle : (a) il délivre une identité de substitution (sorte de « faux-self ») à la personne anorexique qui ne parvient pas à savoir qui elle est, (b) il permet, via cette identité substitutive, d’apparaître comme un individu ultra-performant dont les qualités de discipline et de réussite sont saluées par les autres, (c) il privilégie le rapport immédiat au corps et échappe aux difficultés propres à d’autres formes d’accomplissement individuel, comme le travail, qui mettent le sujet en relation avec une réalité extérieure potentiellement aléatoire et immaîtrisable. Le corps, lui, est a priori directement soumis à la volonté du sujet.

À l’issue de nos analyses, nous pouvons mettre en évidence les articulations nodales de la rémission, qui relèvent de l’acquisition d’une réelle autonomie par le sujet. Celle-ci est indissociable (1) d’une capacité à connaître et à discerner ses états émotionnels internes et à développer une notion immanente du « soi » qui n’est alors plus indexée sur des indices externes ; et (2) corrélativement, d’une aptitude à démêler les signaux inhérents au corps et à atteindre une forme corporelle dont la norme est donnée par le corps lui-même. Quand le corps n’est plus chargé de symboliser une subjectivité dont les notions internes sont trop faibles voire inexistantes (alexithymie et faible sentiment intrinsèque du soi), il peut alors obéir à des normes qui lui sont propres, ce qui constitue le critère du rapport sain au corps. Le rapport pathologique au corps est ainsi celui qui instrumentalise le corps pour en faire la preuve externe compensatoire d’une subjectivité vécue comme inexistante et discontinue ; le rapport sain au corps est celui, qui affranchi de cette finalité d’être le marqueur externe de la subjectivité, peut se régler sur ses propres besoins.

Binge eating disorder (BED) represents one of the most problematic clinical conditions among youths. Research has shown that the developmental stage of adolescence is a critical stage for the onset of eating disorders (EDs), with a peak prevalence of BED at the age of 16–17 years. Several studies among adults with BED have underlined that it is associated with a broad spectrum of negative consequences, including higher concern about shape and weight, difficulties in social functioning, and emotional-behavioral problems. This review aimed to examine studies focused on the prevalence of BED in the adolescent population, its impact in terms of physical, social, and psychological outcomes, and possible strategies of psychological intervention. The review of international literature was made on paper material and electronic databases ProQuest, PsycArticles, and PsycInfo, and the Scopus index were used to verify the scientific relevance of the papers. Epidemiological research that examined the prevalence of BED in adolescent samples in accordance with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition showed a prevalence ranging from 1% to 4%. More recently, only a few studies have investigated the prevalence of BED, in accordance with the Diagnostic and Statistical Manual of Disorders, Fifth Edition criteria, reporting a prevalence of ~1%–5%. Studies that focused on the possible impact that BED may have on physical, psychological, and social functioning showed that adolescents with BED have an increased risk of developing various adverse consequences, including obesity, social problems, substance use, suicidality, and other psychological difficulties, especially in the internalizing area. Despite the evidence, to date, reviews on possible and effective psychological treatment for BED among the young population are rare and focused primarily on adolescent females.

The internet and computers are becoming ubiquitous and mental health services are attempting to utilise these to overcome some of the barriers inherent in standard psychotherapy. In this review, computerised psychotherapy is defined as any computing system which patients are required to interact with to receive their mental health treatment. Computerised CBT (cCBT) has a proven effectiveness in treating some anxiety disorders and depression. Bulimia nervosa (BN) and binge eating disorder (BED) are two mental health conditions which are associated with significant personal and social costs, in addition to low treatment uptake. The current qualitative systematic review aims to investigate whether cCBT is an effective, acceptable and cost-effective treatment for BN and BED. Studies were included if there was a comparison between a control group and cCBT for BN and BED patients. 10 studies were identified and reviewed; eight delivered via the internet (iCBT) and two by CD-ROM (CD-CBT). The samples were predominantly female and the studies’ methodological quality varied, with the majority failing to control for medication and/or additional psychotherapy. The abstinence rates for iCBT and CD-CBT ranged from 22% to 47.6% and 9.1% to 10.2%, respectively. The dropout rates varied from 10% to 45%. Limited evidence was available to assess the cost-effectiveness. The rates of abstinence and dropout are comparable to those found in previous reviews and standard CBT clinical trials. iCBT may be a useful addition to a matched care model. Limitations of the current work and recommendations for future research are discussed.

Celem niniejszej pracy jest przedstawienie problemu zaburzeń odżywiania we współczesnych Chinach oraz próba ukazania związku wpływu tendencji zachodnich z rozwojem chorób takich jak anoreksja czy bulimia w Państwie Środka.
Praca podzielona jest na trzy rozdziały, z czego każdy rozdział zawiera jeszcze podrozdziały dokładniej opisujące dane zagadnienie. Pierwszy rozdział przedstawia po kolei konkretne zaburzenia odżywiania i wyjaśnia, na czym one polegają. Są to: anoreksja nervosa, bulimia nervosa, otyłość oraz mniej popularny BED (binge eating disorder). W dalszej części rozdziału zawarte są konkretne dane, mające na celu przybliżyć czytelnikowi ilość zachorowań na wyżej wymienione choroby w Chinach. Przede wszystkim są to dane na podstawie badań chińskich lekarzy i naukowców dokładniej studiujących te problemy. W kolejnym podrozdziale opisana jest dieta współczesnych Chińczyków i produkty, które najczęściej jedzą.
Drugi rozdział opisuje społeczne i kulturowe uwarunkowania anoreksji i bulimii w Chinach. Przedstawia, jak tradycyjny model chińskiej rodziny może wpływać na poczucie własnej wartości przez współczesnych ludzi oraz w jaki sposób mass media kreują postrzeganie swojego ciała, najczęściej w negatywny sposób. Dodatkowo, w ostatnim podrozdziale drugiego działu autorka zawarła wywiad z obywatelkami Chin, badając ich wiedzę na temat zaburzeń odżywiania oraz tabelkę na podstawie krótkich wywiadów na ten sam temat z innymi Chińczykami.
Ostatni, trzeci rozdział opisuje zaburzenia odżywiania w Chinach na przykładzie konkretnych przypadków. Przedstawione są krótkie historie młodych dziewczyn, które zamieściły opowieści o swoich doświadczeniach związanych z bulimią lub anoreksją na jednym z popularnych chińskich forów internetowych. Dodatkowo, zamieszczony jest też opis filmu dokumentalnego pt.: 《姐妹》 (Jiěmèi) „Siostry”, gdzie przedstawiona jest historia dwóch sióstr, z których jedna cierpi na anoreksję.

ENGLISH:
Eating disorders are becoming more and more common in contemporary Chinese society. They affect not only the young but also the elderly, who find it hard to cope with stress and the fast pace of life. One of the main reasons behind this problem is the promotion of slender bodies in the media.
The aim of this thesis is to discuss the influence of the Western lifestyles on eating disorders, such as anorexia and bulimia, in today’s China. The thesis is divided into three chapters, with further subdivisions, which present three aspects of the problem.
Chapter One is devoted to specific eating disorders: anorexia nervosa, bulimia nervosa, obesity, and less common BED (binge eating disorder). After discussing the symptoms of these disorders, it presents some statistical data based on the research carried out by Chinese doctors and scientists, and concludes with a description of Chinese people’s diet.
Chapter Two focuses on the social and cultural factors related to anorexia and bulimia in China. It discusses the influence of the traditional Chinese family model on the people’s self-esteem, as well as the media’s contribution to the negative perception of their bodies. The final part of the chapter includes the author’s interviews with Chinese women about their knowledge of eating disorders, presented in the form of a table.
Chapter Three presents particular cases of young Chinese girls suffering from anorexia or bulimia as described in their life stories on a popular Chinese Internet forum. This discussion is supplemented by a summary of the documentary called The Sisters, which tells the story of two sisters, one of whom is a victim of anorexia.

In this article we examine the links between anorexia, bulimia and self expression. We start on the hypothesis that an anorexic tries to express himself or herself through his/her skinniness just as a worker tries to express himself/ herself through his/her work. In this respect the anorexic mindset seems to mirror the worker’s.
Yet we will challenge these premises on several grounds:(1) the anorexic, crushed by expectations perceived as unattainable achievements, tries instead to avoid the exaction of being “someone” . (2) skinniness allows him/her to fit into an abstract personal trait rather than assume a specific personality. (3) the anorexic  tries to go beyond mere acceptance rather than seek it.
We will then show how the strategy of anorexia meets with its intrinsic failure: skinniness does not work as a work objective, hence the anorexic is alienated in the Marxian sense. Our conclusion will explore the theme of recovery along two possible pathways.

Dans cet article nous examinons les rapports entre anorexie mentale, boulimie et expression de soi. Nous formulons d’abord l’hypothèse que l’anorexique cherche à s’exprimer dans sa maigreur comme le travailleur s’exprime dans l’objet qu’il produit. La démarche anorexique semble ainsi mimétique par rapport à l’activité du travail. Nous critiquons cependant cette idée à différents niveaux : (1) le sujet anorexique, écrasé par un sens disproportionné des réussites qu’il a à accomplir, cherche plutôt à se soustraire à l’exigence d’être « quelqu’un » ; (2) la maigreur exprime davantage un « genre » abstrait de personnalité qu’une subjectivité singulière ; (3) l’anorexique veut plutôt dépasser la demande de reconnaissance qu’obtenir cette dernière. Nous montrons ensuite comment la stratégie anorexique est constitutivement mise en échec : la maigreur ne fonctionne pas comme l’objet du travail, et à ce titre le sujet anorexique est aliéné : sans objets. Notre conclusion esquisse deux axes sur le thème de la guérison.

This paper seeks to conceptualize the DSM-5's diagnosis of female sexual interest/arousal disorder within the context of individuals struggling with an eating disorder, even long after the "height" of an eating disorder and a woman's re-establishment of healthy body weight.  After exploring the intersection and relationship between eating disorders and sexuality/sexual functioning, the paper proposes a unique case study vignette, clinical assessment, and summary of treatment implications, strategies, and guidelines based on the relatively limited and young body of literature.

Does perfectionism predict maladjustment beyond self-criticism? Attention to this key question is needed as some studies suggest perfectionism may not explain variance in maladjustment beyond self-criticism. Using a large cross-national sample of 524 undergraduates (229 Canadian, 295 British), this study examined whether evaluative concerns perfectionism (socially prescribed perfectionism, concern over mistakes, doubts about actions) explained variance in self-defeating behaviors (binge eating, procrastination, interpersonal conflict) after controlling for selfcriticism. Results showed that—after controlling for self-criticism—concern over mistakes predicted binge eating, doubts about actions predicted procrastination, and socially prescribed perfectionism and concern over mistakes predicted interpersonal conflict. Self-criticism also uniquely predicted self-defeating behaviors beyond evaluative concerns perfectionism. The relationships that evaluative concerns perfectionism shows with self-defeating behaviors appear neither redundant with nor fully captured by self-criticism. Results dovetail with theoretical accounts suggesting evaluative concerns perfectionism is a uniquely important part of the personality of people prone to self-defeating behaviors.

[AMAZON LINK BELOW TO BOOK ITSELF -- TOC and book summary in downloadable .pdf] 

In the modern jungle of burgers, couches, and remote controls, obesity is an enormous and growing epidemic. Weight-loss books and diet gurus urge us to "listen to our bodies," but our instincts are designed for the African savannah, not food courts. The sugary and fatty foods that we, as hunter-gatherers, are programmed to forage used to be hard to come by. Now they're as close as the vending machine down the hall.

Radical changes are necessary and, fortunately, are biologically easier than small or gradual changes in diet. Barrett tells us how to reprogram our bodies, break food addictions, and ignore our attraction to "supernormal stimuli"—artificial creations that appeal to our instincts more than the natural objects they mimic. Barrett delves into scientific research—from animal ethology to evolution—to show the disastrous direction in which our instincts have led us, and how, using our intellect, we can get back on course.  . . . . . . . .An elegantly written and eye-opening analysis of what makes us fat. -- Steven Pinker, PhD, Johnstone Professor of Psychology, Harvard University, and author of How the Mind Works
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In this cogent, clearly argued, and thought-provoking book, Barrett shows how we are paying the price for our own plenty. -- David Spiegel, M.D. Medical Director, Center for Integrative Medicine, Stanford University School of Medicine; author of Living Beyond Limits
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Offers us a way to understand the pandemic of obesity that we find ourselves in. -- John Ratey, M.D. Clinical Associate Professor of Psychiatry Harvard Medical School, co-author of Driven to Distraction

Binge eating disorder (BED) represents one of the most problematic clinical conditions among youths. Research has shown that the developmental stage of adolescence is a critical stage for the onset of eating disorders (EDs), with a peak prevalence of BED at the age of 16-17 years. Several studies among adults with BED have underlined that it is associated with a broad spectrum of negative consequences, including higher concern about shape and weight, difficulties in social functioning, and emotional-behavioral problems. This review aimed to examine studies focused on the prevalence of BED in the adolescent population, its impact in terms of physical, social, and psychological outcomes, and possible strategies of psychological intervention. The review of international literature was made on paper material and electronic databases ProQuest, PsycArticles, and PsycInfo, and the Scopus index were used to verify the scientific relevance of the papers. Epidemiological research that examine...

Background Body dissatisfaction influences women’s mental and physical health. To date, most research has focused on body dissatisfaction in relation to the ‘thin-ideal’. Thus, the association between body dissatisfaction, eating disorder symptomatology and muscularity-ideal in women is less clear. Lack of understanding is underpinned by the lack of reliable and valid muscularity-related assessments for women. To address this need, we developed, tested and re-tested two new body dissatisfaction scales: The Female Body Scale (FBS; adiposity dimension) and Female Fit Body Scale (FFITBS; muscularity dimension). Methods One hundred and fifty-two women in the United Kingdom rated which body figure best represented their current and ideal body, completed the Eating Disorder Examination Questionnaire (EDE-Q 6.0), and their body composition was measured. During re-test, the EDE-Q 6.0 and Drive for Muscularity Scale (DMS) were completed. Results Both the FBS and the FFITBS were found to be v...

This paper describes data on available health care professionals treating patients with eating disorders and obesity in Saudi Arabia and the availability of specialised eating disorders and obesity resources. In this manuscript we are presenting the data obtained from studies conducted in Saudi Arabia and other non-westernized countries during 2017 and before. The database is a useful resource for establishing current statutes and providing bases for future policies and funds.

This study aimed at identifying specific clusters of maladaptive emotional–behavioral symptoms in adolescent victims of motorbike collisions considering their scores on alexithymia and impulsivity in addition to examining the prevalence of clinical binge eating behaviors (respectively through the Youth Self‐Report (YSR), Toronto Alexithymia Scale‐20 (TAS‐20), Barratt Impulsiveness Scale‐11 (BIS‐11), and Binge Eating Scale (BES)). Emotional–behavioral profiles, difficulties in identifying and describing feelings, impulsivity, and binge eating behaviors have been assessed in 159 adolescents addressing emergency departments following motorbike collisions. Our results showed a cluster of adolescents with clinical binge eating behaviors, high rates of motorbike accidents, and high levels of internalizing and externalizing problems, alexithymia, and impulsivity (23.3% of the sample); a second cluster of adolescents with clinical binge eating behaviors, a moderate number of collisions, and moderate levels of emotional and behavioral problems on the above four dimensions (25.8% of the sample); and a third cluster of youth without clinical binge eating behaviors, with a moderate number of accidents, and with low scores on the four dimensions (50.9% of the sample). Adolescents of Cluster 1 showed a higher likelihood to be involved in motorbike collisions than the youth in Clusters 2 and 3 (p < 0.0001). We suggest that adolescents' motor collisions could be associated with their difficulties in emotion regulation and with their impaired psychological profiles, which could also underpin their disordered eating. The identification of specific clusters of psychopathological symptoms among this population could be useful for the construction of prevention and intervention programs aimed at reducing motor collision recidivism and alleviating co‐occurring psychopathologies.

Description du colloque

L'hyperphagie boulimique affecte environ 2% de la population mondiale (2,6% aux États-Unis) et l'obésité, 20% de la population canadienne. La prévalence de l'obésité chez les individus souffrant de maladie bipolaire et de schizophrénie est le double de celle dans la population générale.

Ces troubles alimentaires non-restrictifs sont associés à une multitude de conséquences médicales et psychosociales défavorables. Par ailleurs, la présence d’hyperphagie chez les personnes souffrant d'obésité est associée à un impact négatif plus important sur la santé.

Ce colloque présentera l’état des connaissances sur la prévalence, la présentation clinique, la pathophysiologie et le traitement multimodal de ces conditions.

Clientèle cible

Cette formation est destinée principalement aux psychiatres. Les médecins et les professionnels de la santé qui s’intéressent à l’hyperphagie boulimique et à l’obésité peuvent aussi s’inscrire à cette formation.

Comité scientifique

Dr Yvan Pelletier, psychiatre, adjoint au directeur à la Direction de l’enseignement universitaire du CIUSSS de l’Est-de-l’Île-de-Montréal
Dre Valérie S. Tourjman, psychiatre, chef de service médical au service d’électroconvulsivothérapie du Département de psychiatrie du CIUSSS de l’Est-de-l’Île-de-Montréal
Karine Demers, Chef de service à la Direction de l’enseignement universitaire au CIUSSS de l’Est-de-l’Île-de-Montréal
Tina Tran, Agente de planification, de programmation et de recherche à la Direction de l’enseignement universitaire du CIUSSS de l’Est-de-l’Île-de-Montréal
Objectifs d’apprentissage

Au terme de cette formation, les participants seront en mesure de (d’) :
Expliquer la problématique des troubles alimentaires non-restrictifs (épidémiologie et pathophysiologie)
Décrire les liens entre l’hyperphagie boulimique et l’obésité
Diagnostiquer les troubles alimentaires non-restrictifs
Identifier différentes pistes d’interventions pharmacologiques et non-pharmacologiques pour traiter les troubles alimentaires non-restrictifs, dans une perspective de promotion de la santé

Programme

Un lunch sera servi sur l’heure du dîner.

08:30 - 09:00 Accueil et inscriptions
09:00 - 09:05 Mot de bienvenue
09:05 - 10:05 Épidémiologie et pathophysiologie
10:05 - 10:20 Pause
10:20 - 11:20 Diagnostic
11:20 - 11:30 Période de questions
11:30 - 12:00 Activité Manger en pleine conscience
12:00 - 13:00 Dîner
13:00 - 14:15 Traitements non-pharmacologiques
14:15 - 14:30 Pause
14:30 - 15:30 Traitements pharmacologiques
15:30 - 16:00 Table ronde

Lieu:
Institut universitaire en santé mentale de Montréal
7401, rue Hochelaga
Pavillon Bédard, salle BE-322-18
Montréal, QC H1N 3M5

Responsable:
Tina Tran
tina.tran.cemtl@ssss.gouv.qc.ca

Objectives: To identify the presence of binge eating associated or not with compensatory practices in low-carb dieters. Methods: Binge Eating Scale (BES) and Hay Questionnaire were used in order to assess the frequency of binge eating and compensatory practices, in addition to a frequency questionnaire for the consumption of chocolate, bread and rice. A scale of 1-8 points assessed the carbohydrate restriction intensity, and participants were divided into groups (i) low-carb diet and (ii) control. Comparisons between groups were part of the analysis, as well as correlations between variables of interest per diet group (p < 0.05). Results: Participants were a total of 853 university students, in which 75.97% were women with an average of 22.04 years old (SD = 3.33) and an average BMI of 23.56 kg/m2, (SD = 4.38). From the aforementioned total, 214 had a low-carb diet, and 639 did not. The prevalence of a high score suggestive of binge eating without compensatory practices was 17.94% (n = 153), while the presence of binge eating associated with compensation was 2.23% (n = 19). As for the diet group, 35.05% (n = 75) also performed intermittent fasting. The diet group reached higher values for ECAP and BMI, and lower for frequency of consumption of rice and bread. Furthermore, ECAP scores correlated positively with chocolate consumption (r = + 0.14; p = 0.0377) and BMI values (r = + 0.19; p = 0.0042), whereas carbohydrate restriction showed negative correlation with chocolate consumption (r = - 0.13; p = 0.041); French bread (r = - 0.20; p = 0.0024) and rice (r = - 0.36; p  <0.0001). Conclusions: We highlight the high prevalence of diet practice (25.09%), and the higher levels of binge eating in this group, as well as the lower consumption of rice and bread compared to those who did not diet.

Weight stigma is pervasive in our collective culture, including in our therapy clinics. It can manifest in the physical environment, in the language we use, in the assumptions we make, and in the treatments we deliver. This paper details some of the barriers faced by individuals with larger bodies and how clinicians might acknowledge and address these at both the individual and wider societal levels.

Abstract: Obesity is a chronic condition associated with risk factors for many medical complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways. Evidence-based strategies to improve weight loss, maintain a healthy weight, and reduce related comorbidities typically integrate different interventions: dietetic, nutritional, physical, behavioral, psychological, and if necessary, pharmacological and surgical ones. Such treatments are implemented in a multidisciplinary context with a clinical team composed of endocrinologists, nutritionists, dietitians, physiotherapists, psychiatrists, psycholo...

Objective: The internalization of weight bias is associated with clinically significant eating pathology among overweight adults. However, these relationships have not yet been assessed in lean individuals, who may perceive themselves to be overweight and subsequently internalize weight bias. The aim of the present study, therefore, was to determine whether lean individuals internalize weight bias and if the internalization of weight bias among lean respondents is associated with eating pathology. Method: Participants were 197 lean (mean BMI: 22.28 ± 1.89, range 15.80-24.98) adults who completed the Weight Bias Internalization Scale (WBIS) and measures of disordered eating behaviors and attitudes via an anonymous online survey. Results: Based on convergence of responses from the EDE-Q and QEWP-R, and using DSM-5 behavioral criteria, 10% and 15% of participants were classified into a binge eating and binge/purge group, respectively. WBIS scores were significantly higher among those with binge and/or purge behaviors compared to those without eating pathology. Bivariate correlations revealed positive associations between WBIS score and BMI, depression, and all EDE-Q subscales (restraint, eating concern, shape concern, weight concern). Logistic regressions indicated that internalized weight bias was significantly associated with binge/purge behaviors (OR = 4.67, 95% CI: 2.38-9.17, p b .001) and binge eating (OR = 2.29, 95% CI: 1.26-4.19, p b .01).

Reviews and few non-controlled studies showed the effectiveness of several specific designed computer video-games as an additional form of treatment in several areas. However, there is a lack in the literature of specially designed serious-games for treating mental disorders. Playmancer (ICT European initiative) aims to develop and assess a serious videogame that may help to treat underlying processes (e.g. lack of self-control strategies) in Eating and Impulse control disorders. Preliminary data will be shown.