Patterns of maladaptive exercise behavior from ages 14-24 in a longitudinal cohort

Background: Exercise for weight loss and maladaptive exercise (exercise that results in negative consequences or interference with daily life) are common behaviors among youth and are associated with increased risk of disordered eating symptoms. The current study clarifies processes that influence exercise-related risk in adolescence and young adulthood, including the frequency with which young people transition between engaging in exercise for weight loss and experiencing negative consequences of this behavior. Method: Participants from the Avon Longitudinal Study of Parents and Children (ALSPAC) reported on eating disorder cognitions at age 14, and exercise behavior at ages 14, 16, 18, and 24 years old. Analyses examined rates of transition between the categories of ‘No Exercise for Weight Loss’, ‘Exercise for Weight Loss’, and ‘Maladaptive Exercise’ over time, identified overall trends in endorsement of exercise for weight loss and maladaptive exercise, and clarified predictors of these behaviors. Results: Endorsement of exercise for weight loss and maladaptive exercise increased over time in both males and females. Those in the ‘Exercise for Weight Loss’ category were more likely than those in the ‘No Exercise for Weight Loss Category’ to transition to ‘Maladaptive Exercise’ over time. Body mass index (Age 13) and fear of weight gain (Age 14) were consistent predictors of maladaptive exercise across sex. Conclusions: Results support re-framing motivations for exercise in youth away from weight loss at a population level and targeting reductions in fear of weight gain for high-risk individuals

Maternal eating disorder and infant diet. A latent class analysis based on the Norwegian Mother and Child Cohort Study (MoBa)

Knowledge of infant diet and feeding practices among children of mothers with eating disorders is essential to promote healthy eating in these children. This study compared the dietary patterns of 6-month-old children of mothers with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorder not otherwise specified - purging subtype, to the diet of children of mothers with no eating disorders. The study was based on 53,879 mothers in the Norwegian Mother and Child Cohort Study (MoBa). Latent class analysis (LCA) was used to identify discrete latent classes of infant diet based on the mothers’ responses to questions about 16 food items. LCA identified five classes, characterized by primarily homemade vegetarian food (4% of the infants in the sample), homemade traditional food (8%), commercial infant cereals (35%), commercial jarred baby food (39%), and a mix of all food groups (11%). We then estimated the association between the different latent dietary classes and maternal eating disorders using a multinomial logistic regression model. Infants of mothers with bulimia nervosa had a lower probability of being in the homemade traditional food class compared to the commercial jarred baby food class, than the referent without an eating disorder (O.R. 0.59; 95% CI 0.36–0.99). Infants of mothers with binge eating disorder had a lower probability of being in the homemade vegetarian class compared to the commercial jarred baby food class, than the referent (O.R. 0.77; 95% CI 0.60–0.99), but only before controlling for relevant confounders. Anorexia nervosa and eating disorder not otherwise specified-purging subtype were not statistically significant associated with any of the dietary classes. These results suggest that in the general population, maternal eating disorders may to some extent influence the child’s diet as early as 6 months after birth; however, the extent to which these differences influence child health and development remain an area for further inquiry

Genetic epidemiology of eating disorders

We capture recent findings in the field of genetic epidemiology of eating disorders. As analytic techniques evolve for twin, population, and molecular genetics, new findings emerge at an accelerated pace. We present the current status of knowledge regarding the role of genetic and environmental factors that influence risk for eating disorders

Can attention to the intestinal microbiota improve understanding and treatment of anorexia nervosa?

Anorexia nervosa (AN) is characterized by severe dietary restriction or other weight loss behaviors and exhibits the highest mortality rate of any psychiatric disorder. Therapeutic renourishment in AN is founded primarily on clinical opinion and guidelines, with a weak evidence base. Genetic factors do not fully account for the etiology of AN, and non-genetic factors that contribute to the onset and persistence of this disease warrant investigation. Compelling evidence that the intestinal microbiota regulates adiposity and metabolism, and more recently, anxiety behavior, provides a strong rationale for exploring the role of this complex microbial community in the onset, maintenance of, and recovery from AN. This review explores the relationship between the intestinal microbiota and AN and a potential role for this enteric microbial community as a therapy for this severe illness

Prevalence and correlates of binge eating disorder related features in the community

Binge eating disorder (BED) is associated with high levels of obesity and psychological suffering, but little is known about 1) the distribution of features of BED in the general population and 2) their consequences for weight development and psychological distress in young adulthood. We investigated the prevalence of features of BED and their association with body mass index (BMI) and psychological distress among men (n = 2423) and women (n = 2825) from the longitudinal community-based FinnTwin16 cohort (born 1975-1979). Seven eating-related cognitions and behaviors similar to the defining features of BED were extracted from the Eating Disorder Inventory-2 and were assessed at a mean age of 24. BMI and psychological distress, measured with the General Health Questionnaire, were assessed at ages 24 and 34. We assessed prevalence of the features and their association with BMI and psychological distress cross-sectionally and prospectively. More than half of our participants reported at least one feature of BED; clustering of several features in one individual was less common, particularly among men. The most frequently reported feature was 'stuffing oneself with food', whereas the least common was 'eating or drinking in secrecy'. All individual features of BED and their clustering particularly were associated with higher BMI and more psychological distress cross-sectionally. Prospectively, the clustering of features of BED predicted increase in psychological distress but not additional weight gain when baseline BMI was accounted for. In summary, although some features of BED were common, the clustering of several features in one individual was not. The features were cumulatively associated with BMI and psychological distress and predicted further increase in psychological distress over ten years of follow-up. (C) 2016 Published by Elsevier Ltd.Peer reviewe

Genetics and Epigenetics of Eating Disorders

Two key features characterize a modern view of eating disorder etiology. First, almost all risk and protective factors, both genetic and environmental, are probabilistic, rather than deterministic. Second, the old debate pitting nature against nurture is overly simplistic. Nature and nurture represent opposite sides of the same etiological coin rather than opposing influences. Eating disorder psychopathology is a function of nature and nurture rather nature or nurture. Therefore, the foremost goal of current genetic research on eating disorders is to identify all loci and pathways that confer risk or protection. The key advantage of genetic studies is that causation can be inferred because exposure to the genetic risk factor begins at conception and before disease onset. The second goal is to discover the pathophysiology underlying eating disorder development. The third is to use identified loci to inform prevention and treatment approaches

The neurostructural and neurocognitive effects of physical activity: A potential benefit to promote eating disorder recovery.

Accumulating evidence suggests that supervised and adapted physical activity pro-vides cognitive benefits for individuals with eating disorders (EDs). The mechanismsunderlying the benefits of physical activity are poorly understood. Addressing thisknowledge gap may inform the appropriate integration of structured physical activityinto eating disorders treatment and recovery. We draw attention to recent findingsin the study of the impact of physical activity on the brain, and we describe the neu-rostructural and neurocognitive changes associated with physical activity observed invarious clinical and nonclinical populations. Considering the identified impairment inbrain volume- and/or neurocognitive function in various EDs, we propose that posi-tive effects of physical activity may play a meaningful role in successful ED treat-ment. Accordingly, we outline research steps for closing the knowledge gap on howphysical activity may aid in ED recovery, and emphasize the need to combine mea-sures of cognitive and behavioral responses to physical activity, with technologycapable of measuring changes in brain structure and/or function.publishedVersio

Environmental and Genetic Risk Factors for Eating Disorders: What the Clinician Needs to Know

Patients and families are often aware of research on genetic factors influencing eating disorders. Accurate interpretations of research on environmental and genetic risk factors can be empowering to patients and families; however, misinterpretations could prove detrimental. The clinician who is not versed in genetic research may feel ill-prepared to discuss the nuances of genetic research with patients and families. In this paper the authors discuss what is known about genetic and environmental risk factors with an emphasis on gene-environment interplay in order to increase clinicians’ comfort level with discussing these complex issues with their patients

Prevalence and contributing factors to recurrent binge eating and obesity among black adults with food insufficiency: findings from a cross-sectional study from a nationally-representative sample

Background: Living in a food-insecure or food insufficient household may increase risk for binge eating and obesity. Because racial disparities in food access, obesity, and access to treatment for disordered eating exist, it is important to examine these relationships in Black populations. Methods: We conducted a secondary analysis of data from the National Survey of American Life (N = 4553), a nationally- representative sample of Black Americans, including African Americans and Afro-Caribbeans. Logistic regression was used to explore the association of food insufficiency with obesity and binge eating. Results: In the total sample of Black Americans, the prevalence of food insufficiency was 10.9% (95% CI 10.0–11.8%). Food insufficiency was not significantly associated with obesity in Black Americans, but when associations were explored in analyses stratified by ethnicity and sex, food insufficiency significantly predicted an increased odds of obesity in Afro-Caribbeans (odds ratio [OR] = 1.47, 95% CI 1.01, 2.13). Individuals experiencing food insufficiency were more likely to report recurrent binge eating in the last 12 months (3% v 2%, P = 0.02) and a lifetime history of binge eating (6% v 3%, P = 0.004) compared to those who were food sufficient. After adjusting for socio-demographic factors, food insufficiency was not significantly associated with recurrent binge eating in Black Americans or in sex- and ethnicity-stratified analyses. Conclusion: The present study reveals a more complex relation between food insufficiency and binge eating than previously thought—although an association existed, it was attenuated by an array of sociodemographic factors. Our results also underscore the importance of considering ethnicity as different patterns emerged between African American and Afro-Caribbean participant

Prospective associations between childhood social communication processes and adolescent eating disorder symptoms in an epidemiological sample

Deficits in social cognition and communication, the processes associated with human social behavior and interaction, have been described in individuals with eating disorder psychopathology. The current study examined whether social communication characteristics present in middle childhood (ages 8–14) were associated with eating disorder behaviors, cognitions, and diagnoses across adolescence (ages 14–18) in a large, population-based sample. Participants (N = 4864) were children enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based, prospective study of women and their children. Regression methods tested prospective associations between social functioning using a facial emotion recognition task and parentally reported social communication symptoms (or difficulties), measured by the Social Communication Disorder Checklist (SCDC), with eating disorder symptoms and diagnoses. Misattribution of faces as sad or angry at age 8.5 was associated with purging and anorexia nervosa diagnosis at age 14, respectively, among girls. Furthermore, autistic-like social communication difficulties during middle childhood were associated with bulimia nervosa symptoms during adolescence among both girls and boys. Results did not support global associations between measured social communication deficits and eating disorder risk in this sample, but specific difficulties with facial emotion recognition and social communication may enhance the risk for disordered eating behaviors