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Problematic Eating Behaviors and Eating Disorders Associated with Bariatric Surgery.
Brode, CS, Mitchell, JE
The Psychiatric clinics of North America. 2019;(2):287-297
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Abstract
Bariatric surgery candidates often report problematic and/or eating disordered behaviors. For most patients, these eating behaviors improve after surgery. A subset, however, experience a recurrence or new onset of problematic eating behaviors as early as 2 months to 18 months after surgery, which can result in compromised weight loss/excessive weight regain. Those most at risk are individuals with comorbid psychopathology (ie, loss-of-control eating or depression) after surgery. For some, such problems are present before surgery. Therefore, it is critical to monitor patients closely after surgery so that appropriate psychiatric treatments can be provided if indicated.
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Psychosocial Concerns Following Bariatric Surgery: Current Status.
Kalarchian, MA, Marcus, MD
Current obesity reports. 2019;(1):1-9
Abstract
PURPOSE OF REVIEW The purpose of this paper is to review the current status of research on psychosocial concerns following bariatric surgery. RECENT FINDINGS Bariatric surgery has a positive overall impact on weight and obesity-related comorbidities, as well as a positive short-term impact on mental health and psychosocial functioning. Nonetheless, research has documented a number of different psychosocial concerns that may emerge following surgery including maladaptive eating, substance use disorders, suicide, lack of social support, and excess skin. Moreover, special populations of patients may have distinctive psychosocial concerns based on sociodemographic factors such as age or severity of obesity. Available studies suggest that psychosocial interventions have a positive impact on post-surgery outcomes, particularly maladaptive eating. However, research is limited, and long-term data are lacking. Monitoring patients after bariatric surgery for negative psychosocial outcomes is warranted. Research is needed to develop and evaluate personalized approaches to optimize long-term weight loss and psychosocial adjustment.
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Adverse Birth Outcomes Associated with Types of Eating Disorders: A Review.
Charbonneau, KD, Seabrook, JA
Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada. 2019;(3):131-136
Abstract
At least 5% of women have an eating disorder (ED) during pregnancy. These EDs affect prepregnancy body mass index (BMI) and weight gain during pregnancy, factors associated with birth complications and adverse neonatal outcomes. This review contributes to the literature by examining several adverse birth outcomes associated with EDs and differentiates between past and present EDs. Of the 18 articles reviewed, EDs were associated with preterm birth in 5/14 (36%) and small-for-gestational-age in 5/8 (63%) studies. Anorexia Nervosa increases the odds of a low birth weight baby, particularly when women enter pregnancy with a low BMI. Binge Eating Disorder is positively associated with having a large-for-gestational-age infant, and Bulimia Nervosa is associated with miscarriage when symptomatic during pregnancy. Having a current ED increases the risk for adverse birth outcomes more than a past ED. Since the aetiology of adverse birth outcomes is multi-factorial, drawing conclusions about causal relationships between EDs and birth outcomes is problematic given the small number of studies reporting these outcomes. Resources should target preconception interventions that put EDs into remission and help women achieve a healthier BMI prior to pregnancy, as these have been consistently shown to improve birth outcomes.
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Obesity and Eating Disturbance: the Role of TFEQ Restraint and Disinhibition.
Bryant, EJ, Rehman, J, Pepper, LB, Walters, ER
Current obesity reports. 2019;(4):363-372
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Abstract
PURPOSE OF REVIEW Literature from the past five years exploring roles of Three-Factor Eating Questionnaire (TFEQ) Restraint and Disinhibition in relation to adult obesity and eating disturbance (ED) was reviewed. RECENT FINDINGS Restraint has a mixed impact on weight regulation, diet quality, and vulnerability to ED, where it is related detrimentally to weight regulation, diet, and psychopathology, yet can serve as a protective factor. The impact of Disinhibition is potently related to increased obesity, poorer diet, hedonically driven food choices, and a higher susceptibility to ED. Restraint and Disinhibition have distinct influences on obesity and ED and should be targeted differently in interventions. Further work is required to elucidate the mechanisms underlying TFEQ eating behavior traits.
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Stigma control model of dysregulated eating: A momentary maintenance model of dysregulated eating among marginalized/stigmatized individuals.
Mason, TB, Smith, KE, Lavender, JM
Appetite. 2019;:67-72
Abstract
Stigma is a factor commonly experienced by marginalized groups that may serve as a maintenance factor for dysregulated eating. In the current paper, we propose a momentary maintenance model, grounded in previous theoretical and empirical research, termed the stigma control model of dysregulated eating. Our model proposes that momentary experiences of stigma lead to emotional distress, which in turn is associated with engagement in numerous maladaptive stigma management strategies intended to curb future stigma. These stigma management strategies, however, serve to increase emotional distress, which in turn promotes dysregulated eating. This model has applications for understanding the maintenance of dysregulated eating among marginalized groups, as well as implications for developing novel treatments and refining existing treatments for dysregulated eating. Future studies should use methods that capture momentary experiences to evaluate the proposed stigma control model of dysregulated eating.
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The relationship between risk of eating disorders, age, gender and body mass index in medical students: a meta-regression.
Jahrami, H, Saif, Z, Faris, MA, Levine, MP
Eating and weight disorders : EWD. 2019;(2):169-177
Abstract
PURPOSE Age, gender and body mass index (BMI) are commonly described risk factors for the development of eating disorders. However, the magnitude of these factors (individually and together) is still not well-defined in some populations. METHODS A systematic search was performed for studies that reported the prevalence of eating disorder risk among medical students using the Eating Attitudes Test-26 (EAT-26) and age, gender and BMI as risk factors. We included studies published in English peer-reviewed journals between 1982 and 2017. A total of 14 studies were included in the analyses, and the meta-regression analyses were performed using mean age (years), gender (proportion of female subjects), and mean BMI (kg/m2) as moderators with the risk of eating disorders measured using EAT-26 as an outcome variable. Four interaction terms were created (1) age × gender (2) age × BMI (3) gender × BMI and (4) age × gender × BMI to assess if two or more independent variables simultaneously influence the outcome variable. RESULTS Utilizing the EAT-26, the pooled prevalence of at risk for eating disorders among medical students (k = 14, N = 3520) was 10.5% (95% CI 7.3-13.7%). Meta-regression model of age, gender and BMI alone revealed poor predictive capabilities. Meta-regression model of age × gender × BMI interaction revealed statistically significant results with a covariate coefficient of 0.001 and p value of 0.044. CONCLUSION Results from this sample of medical students provided evidence for the role of interactions between risk factors (e.g., age × gender × BMI) in predicting individuals at risk for eating disorders, whereas these variables individually failed to predict eating disorders. LEVEL OF EVIDENCE Level I, systematic review and meta-analysis.
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Rigor and reproducibility in genetic research on eating disorders.
Hübel, C, Leppä, V, Breen, G, Bulik, CM
The International journal of eating disorders. 2018;(7):593-607
Abstract
OBJECTIVE We explored both within-method and between-method rigor and reproducibility in the field of eating disorders genetics. METHOD We present critical evaluation and commentary on component methods of genetic research (family studies, twin studies, molecular genetic studies) and discuss both successful and unsuccessful efforts in the field. RESULTS Eating disorders genetics has had a number of robust results that converge across component methodologies. Familial aggregation of eating disorders, twin-based heritability estimates of eating disorders, and genome-wide association studies (GWAS) all point toward a substantial role for genetics in eating disorders etiology and support the premise that genes do not act alone. Candidate gene and linkage studies have been less informative historically. DISCUSSION The eating disorders field has entered the GWAS era with studies of anorexia nervosa. Continued growth of sample sizes is essential for rigorous discovery of actionable variation. Molecular genetic studies of bulimia nervosa, binge-eating disorder, and other eating disorders are virtually nonexistent and lag seriously behind other major psychiatric disorders. Expanded efforts are necessary to reveal the fundamental biology of eating disorders, inform clinical practice, and deliver new therapeutic targets.
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Non-invasive brain stimulation for food cravings, consumption, and disorders of eating: A review of methods, findings and controversies.
Hall, PA, Vincent, CM, Burhan, AM
Appetite. 2018;:78-88
Abstract
OBJECTIVE To describe the state of the human research literature pertaining to the use of non-invasive brain stimulation (NIBS) procedures for modulating food cravings, food consumption, and treating disorders of eating (i.e., obesity, bulimia nervosa, and anorexia nervosa). METHODS A narrative review of methods, empirical findings, and current areas of controversy. Both single-session experimental and multi-session therapeutic modalities are considered, separately for repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) technologies. RESULTS Single-session studies involving NIBS report more consistent effects of rTMS than tDCS, but this advantage is more clear in relation to food cravings than actual food consumption. Multisession therapeutic approaches have been applied to both obesity and eating disorders. With respect to obesity, the three published (tDCS) and one ongoing trial (rTMS) have yielded promising though very preliminary findings. Application of multi-session NIBS (predominantly rTMS) to eating disorders has also yielded promising but ultimately inconclusive results, both in relation to bulimia nervosa and binge eating disorder. Findings regarding excitatory NIBS in the context of anorexia are more controversial, with evidence of improvement in affective functioning, but a trend of iatrogenic weight loss. CONCLUSIONS Excitatory NIBS-particularly rTMS-can reliably reduce food cravings in single and multi-session format. For multi-session treatment of clinical conditions, more studies are needed for both rTMS and tDCS, particularly in relation to obesity, bulimia, and binge eating disorder. Application of NIBS for anorexia is less clear at this point, and excitatory NIBS may be contraindicated on theoretical and empirical grounds.
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Predictors and outcomes of the Neonatal Oral Motor Assessment Scale (NOMAS) performance: a systematic review.
Longoni, L, Provenzi, L, Cavallini, A, Sacchi, D, Scotto di Minico, G, Borgatti, R
European journal of pediatrics. 2018;(5):665-673
Abstract
UNLABELLED The NOMAS is by far the most used tool to screen early oral-motor skills in newborns. Here we provide an updated review of scientific literature on the use of the Neonatal Oral Motor Assessment Scale (NOMAS) to screen early oral-motor skills in newborns. An integrative review has been carried out consistent with PRISMA guidelines and standardized qualitative appraisal. Data abstracting and synthesis were executed by two independent co-authors who solved disagreement in conference. Twenty records have been included and reviewed. The efficacy of the NOMAS in screening and identifying precocious oral-motor skills received inconsistent support. Moderate validity and low reliability emerged. Moreover, despite the NOMAS' adequately screen efficient and inefficient feeders, limited evidence emerged for predictive value of NOMAS score on feeding and psychomotor developmental trajectories during the first 2 years of age. CONCLUSION The present review highlights benefits and limitations of the NOMAS. Future research is needed to develop observational and clinically-relevant tools to better identify newborns which are at lower- and higher-risk of developing less-than-optimal feeding behaviors and to guide with greater precision the diagnostic and therapeutic journey of these newborns. What is Known: • The assessment of oral-motor skills in newborns and infants is critical for early intervention • The NOMAS is the most adopted tool to assess oral-motor skills in newborns and infants What is New: • The ability of the NOMAS to target newborn at risk for feeding disorders is confirmed • Nonetheless, the capacity to predict long-term developmental outcomes is limited.
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Definitions and Clinical Guidance on the Enteral Dependence Component of the Avoidant/Restrictive Food Intake Disorder Diagnostic Criteria in Children.
Dovey, TM, Wilken, M, Martin, CI, Meyer, C
JPEN. Journal of parenteral and enteral nutrition. 2018;(3):499-507
Abstract
The aim of the current article is to offer definitive guidance on weaning children who are reliant on nasogastric/gastrostomy feeding tubes. To date, no internationally recognized definitions or principles for interventions exist, and clinics have been reliant on creating their own unique intervention criteria. To achieve the aim, 2 goals are set out within the current article. The first goal was to definitively define the process of tube weaning. To achieve this, both tube dependency and oral eating also required definitions. It is necessary for these 2 additional definitions to fully understand the process of tube weaning and the transition that the child is making within these clinical interventions. The second goal of this article was to propose a set of minimum measurement criteria within a tube weaning protocol so that different clinical practices and perspectives may be measured accurately. This would then allow outcomes from different clinical services to be compared for efficacy. The culmination of this article is a set of 5 core principles that should govern clinics that adhere to the auspices of evidence-based practice. These principles, if adopted, will provide the basis of a set of internationally recognized criteria within this field of pediatric gastroenterology.