The phenomenology of childhood and adolescent loss of control (LOC) eating is unknown. The authors interviewed 445 youths to assess aspects of aberrant eating. LOC was associated with eating NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript forbidden food before the episode; eating when not hungry; eating alone; and experiencing secrecy, negative emotions, and a sense of "numbing" while eating (ps < .01). Hierarchical cluster analysis revealed a subgroup, most of whom reported LOC eating. Cluster members reported having a trigger initiate episodes, eating while watching television, and having decreased awareness regarding the amount consumed. The authors conclude that aspects of LOC eating during youth are similar to aspects of adult episodes, but a youth-specific presentation may exist. Findings may provide an intervening point to prevent excessive weight gain and eating disorders.Keywords binge eating; loss of control eating; children; adolescentsThe prevalence of pediatric overweight has nearly tripled in recent years (Ogden et al., 2006). Overweight during youth puts individuals at high risk for becoming obese adults (Field, Cook, & Gillman, 2005;Freedman, Khan, Dietz, Srinivasan, & Berenson, 2001;Guo, Wu, Chumlea, & Roche, 2002;Whitaker, Wright, Pepe, Seidel, & Dietz, 1997;Williams, 2001). Given the serious untoward medical (Adams et al., 2006;Freedman et al., 2001) and psychosocial (Puhl & Brownell, 2002;Strauss & Pollack, 2003) consequences of excess weight, overweight during childhood and adolescence is a major public health problem. Prevention and early intervention are critical to reduce the current epidemically high prevalence of pediatric overweight (Styne, 2003). Targeting behavioral factors that promote excessive weight gain may be a potential point of intervention. However, clarification of relevant behavioral factors is required before prevention efforts may be designed and implemented.Binge eating is defined as eating a large amount of food given the context, during which a sense of lack of control over eating is experienced (American Psychiatric Association [APA], 2000). Recurrent binge eating is the hallmark behavior of binge eating disorder BED; (APA, 2000). Compared to obese adults without an eating disorder, adults with BED suffer from poorer physical health (J. G. Johnson, Spitzer, & Williams, 2001) and higher levels of eating disorder psychopathology (e.g., Masheb & Grilo, 2000;Wilfley et al., 2000) and are more likely to be diagnosed with a comorbid psychiatric disorder (e.g., Marcus, 1995;Wilfley et al., 2000;Yanovski, Nelson, Dubbert, & Spitzer, 1993). BED and subthreshold binge eating are often associated with excess body weight and obesity (de Zwaan, 2001;Yanovski et al., 1993). Not only is BED a disorder of clinical significance (Wilfley, Wilson, & Agras. 2003), but some (Sherwood, Jeffery, & Wing, 1999;Yanovski, Gormally, Leser, Gwirtsman, & Yanovski, 1994), although not all (Wadden, Foster, & Letizia, 1992), data suggest that the presence of the ...

This study sought to examine risk and onset patterns in anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Women with AN (n=71), BN (n=66), BED (n=160) and non-psychiatric controls (n=323) were compared retrospectively on risk factors, symptom onset, and diagnostic migration. Eating disorder groups reported greater risk exposure than non-psychiatric controls. AN and BED differed on premorbid personality/behavioral problems, childhood obesity, and family overeating. Risk factors for BN were shared with AN and BED. Dieting was the most common onset symptom in AN, whereas binge eating was most common in BN and BED. Migration between AN and BED was rare, but more frequent between AN and BN and between BN and BED. AN and BED have distinct risk factors and onset patterns, while BN shares similar risk factors and onset patterns with both AN and BED. Results should inform future classification schemes and prevention programs.

Findings suggest that an Internet-delivered intervention yielded a modest reduction in weight status that continued 4 months after treatment and that ED attitudes/behaviors were not significantly improved. Group differences on weight loss were not sustained at 4-month follow-up because of parallel improvements in the groups. Future studies are needed to improve program adherence and to further explore the efficacy of Internet-delivery of weight control programs for adolescents.

Disordered eating attitudes and behaviors appear to be quite common in youth, and overweight youth have been identified as a subset of the population at particularly high risk for endorsing such symptoms. Overweight and eating disorder (ED) symptomatology independently confer significant threats to one's physical and psychosocial health, showing strong links with body weight gain and risk for ED development. When concurrent, the risk for negative health outcomes may be compounded. The purpose of this article is to review the current state of the literature as it concerns disordered eating and its correlates in overweight children and adolescents. Extant literature on the prevalence, distribution, correlates, and etiology of disordered eating attitudes and behaviors (i.e., negative attitudes toward shape and weight, unhealthy weight control behaviors, and binge eating) in overweight youth is reviewed and consolidated in order to make assessment and treatment recommendations for healthcare providers. The current literature suggests that early detection of disordered eating in overweight youth should be a priority to provide appropriate intervention, thereby helping to slow the trajectory of weight gain and prevent or reduce the long-term negative consequences associated with both conditions. Future research should focus on explicating developmental pathways, and on developing novel prevention and treatment interventions for overweight youth exhibiting disordered eating patterns.

Background Binge eating is a marker of weight gain and obesity, and a hallmark feature of eating disorders. Yet, its component constructs—overeating and loss of control (LOC) while eating—are poorly understood and difficult to measure. Objective To critically review the human literature concerning the validity of LOC and overeating across the age and weight spectrum. Data sources English-language articles addressing the face, convergent, discriminant, and predictive validity of LOC and overeating were included. Results LOC and overeating appear to have adequate face validity. Emerging evidence supports the convergent and predictive validity of the LOC construct, given its unique cross-sectional and prospective associations with numerous anthropometric, psychosocial, and eating behavior-related factors. Overeating may be best conceptualized as a marker of excess weight status. Limitations Binge eating constructs, particularly in the context of subjectively large episodes, are challenging to measure reliably. Few studies addressed overeating in the absence of LOC, thereby limiting conclusions about the validity of the overeating construct independent of LOC. Additional studies addressing the discriminant validity of both constructs are warranted. Discussion Suggestions for future weight-related research and for appropriately defining binge eating in the eating disorders diagnostic scheme are presented.

The YEDE-Q appears promising in the assessment of eating-related pathology in overweight adolescents, but remains in need of validation in children and ED populations.

Objective Negative affect precedes binge eating and purging in bulimia nervosa (BN), but little is known about factors that precipitate negative affect in relation to these behaviors. We aimed to assess the temporal relation among stressful events, negative affect, and bulimic events in the natural environment using ecological momentary assessment. Method A total of 133 women with current BN recorded their mood, eating behavior, and the occurrence of stressful events every day for two weeks. Multi-level structural equation mediation models evaluated the relations among Time 1 stress measures (i.e., interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal), Time 2 negative affect, and Time 2 binge eating and purging, controlling for Time 1 negative affect. Results Increases in negative affect from Time 1 to Time 2 significantly mediated the relations between Time 1 interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal, and Time 2 binge eating and purging. When modeled simultaneously, confidence intervals for interpersonal stressors, general daily hassles, and stress appraisal did not overlap, suggesting that each had a distinct impact on negative affect in relation to binge eating or purging. Conclusions Our findings indicate that stress precedes the occurrence of bulimic behaviors and that increases in negative affect following stressful events mediate this relation. Results suggest that stress and subsequent negative affect may function as maintenance factors for bulimic behaviors and should be targeted in treatment.

Classifying eating disorders in youth is challenging in light of developmental considerations and high rates of diagnostic migration. Understanding the transactional relationships among eating disorder symptoms, both across the transdiagnostic spectrum and within specific diagnostic categories, may clarify which core eating disorder symptoms contribute to, and maintain, eating-related psychopathology in youth. We utilized network analysis to investigate interrelationships among eating disorder symptoms in 636 treatment-seeking children and adolescents (90.3% female) ages 6-18 years (M age = 15.4 ± 2.2). An undirected, weighted network of eating disorder symptoms was created using behavioral and attitudinal items from the Eating Disorder Examination. Across diagnostic groups, symptoms reflecting appearance-related concerns (e.g., dissatisfaction with shape and weight) and dietary restraint (e.g., a desire to have an empty stomach) were most strongly associated with other eating disorder symptoms in the network. Binge eating and compensatory behaviors (e.g., self-induced vomiting) were strongly connected to one another but not to other symptoms in the network. Network connectivity was similar across anorexia nervosa, bulimia nervosa, and otherwise specified feeding or eating disorder subgroups. Among treatment-seeking children and adolescents, dietary restraint and shape- and weight-related concerns appear to play key roles in the psychopathology of eating disorders, supporting cognitive-behavioral theories of onset and maintenance. Similarities across diagnostic categories provide support for a transdiagnostic classification scheme. Clinical interventions should seek to disrupt these symptoms early in treatment to achieve maximal outcomes. (PsycINFO Database Record