Oliva Rosella Euro Weight Loss-2015 Frankfurt, Germany August 18 – 20, 2015.

Oliva Rosella

Euro Weight Loss-2015Frankfurt, Germany

August 18 – 20, 2015

OBESITYTHE RELATIONSHIP BETWEEN BINGE EATING DISORDER AND FOOD ADDICTION

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

Rossella Oliva - Euro Weight Loss 2015

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)


“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)


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)


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


HYPOTHESIS

1) Food addiction as a causal factor for chronic overeating

2) Food addiction as a valid phenotype of obesity


BED/FOOD ADDICTION/OBESITY

OBESITY

BED

FA

OBESITY

FABED

OBESITY

BED

FA


OVERCOMING HETEROGENEOUS DEFINITIONS


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.



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

THE RESEARCH


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.


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


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)


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)


RESULTS


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)


OBSERVED FREQUENCIES

YFAS (+) YFAS (-)

BES (+) 35 (37%) 8 (9%)

BES (-) 18 (19%) 33 (35%)


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*


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


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.


THANK YOU FOR YOUR ATTENTION

Rossella Oliva

[email protected]+39 340 530 44 65


BINGE EATING

GUILT

PLEASURE

MOOD DYSREGULATION

IMPULSIVITYBMI

LACK OF CONTROL

RESTRICTION

FOOD ADDICTION

BINGE EATING DISORDER


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

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.