Loss of control is central to psychological disturbance associated with binge eating disorder
Loss of control is central to psychological disturbance associated with binge eating disorder
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DOI：
10.1038/oby.2007.99
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发表时间：
2008-03-01
期刊：
影响因子：
6.9
通讯作者：
O'Brien, Paul E.
中科院分区：
文献类型：
--
作者：
Colles, Susan L.;Dixon, John B.;O'Brien, Paul E.
目的：暴食症（BED）与肥胖和心理困扰呈正相关，但BED的行为特征驱动这些关联在很大程度上尚未被探索。本研究的主要目的是探讨暴饮暴食的哪些核心行为特征与心理障碍的关系最为密切。方法和程序：一项横断面研究涉及180名减肥手术候选人，93名非手术减肥支持小组成员和158名普通社区受访者（81名男性/350名女性，平均年龄45.8 +/- 13.3，平均BMI 34.8 +/- 10.8， BMI范围17.7-66.7）。经过验证的问卷评估了BED和暴饮暴食、抑郁症状、外观不满（AD）、生活质量（QoL）和饮食相关行为。通过访谈确认暴食的特征。BMI由临床评估和自我报告确定。结果：饮食失控（LOC），即无法停止进食或无法控制进食的内容和数量，与BED患者常见的困扰心理指标关系最为密切。特别是，那些因LOC感觉而经历严重情绪障碍的人报告了更高的抑郁症状（P < 0.001）、AD （P = 0.009）和更差的精神健康相关生活质量（P = 0.027）。讨论：报告主观暴食发作或不符合客观暴食发作BED频率标准的人可能仍有较高的心理障碍风险，并可从临床干预中获益。LOC的感觉可能会驱使暴饮暴食者寻求减肥手术，试图控制体重和心理上令人不安的饮食行为。
Objective: Binge eating disorder (BED) is positively associated with obesity and psychological distress, yet the behavioral features of BED that drive these associations are largely unexplored. The primary aim of this study was to investigate which core behavioral features of binge eating are most strongly related to psychological disturbance.Methods and Procedures: A cross-sectional study involved 180 bariatric surgery candidates, 93 members of a non-surgical weight loss support group, and 158 general community respondents (81 men/350 women, mean age 45.8 +/- 13.3, mean BMI 34.8 +/- 10.8, BMI range 17.7-66.7). Validated questionnaires assessed BED and binge eating, symptoms of depression, appearance dissatisfaction (AD), quality of life (QoL) and eating-related behaviors. Features of binge eating were confirmed by interview. BMI was determined by clinical assessment and self-report.Results: The loss of control (LOC) over eating, that is, being unable to stop eating or control what or how much was consumed was most closely related to psychological markers of distress common in BED. In particular, those who experienced severe emotional disturbance due to feelings of LOC reported higher symptoms of depression (P < 0.001), AD (P = 0.009), and poorer mental health-related QoL (P = 0.027).Discussion: Persons who report subjective binge episodes or do not meet BED frequency criteria for objective binge episodes may still be at elevated risk of psychological disturbance and benefit from clinical intervention. Feelings of LOC could drive binge eaters to seek bariatric surgery in an attempt to gain control over body weight and psychologically disturbing eating behavior.