Impulsivity and test meal intake among women with bulimia nervosa

Abstract

Many patients with bulimia nervosa (BN) also meet criteria for a lifetime alcohol use disorder (AUD). In order to understand possible mechanisms contributing to the co-occurrence and perpetuation of these disorders, this study investigated the importance of impulsivity and test meal intake among patients with BN by comparing women with BN only (n = 18), BN and current/past AUDs (n = 13), and healthy controls (n = 12). All participants completed assessments of eating disorder symptoms, frequency of alcohol use, binge eating, and purging via questionnaires and semi-structured interviews over two sessions. Measures of impulsivity consisted of computerized and self-report measures, and laboratory test meals. Significant differences between individuals with BN with/without comorbid AUDs were not found for test meal intake, impulsivity measures, or self-reported psychological symptoms. As hypothesized, compared to healthy controls, individuals with BN had significantly higher scores on two subscales and the total score of the Barratt Impulsiveness Scale, a trait measure of impulsivity, and consumed significantly more calories in the binge instruction meal. Total Barratt Impulsiveness Scale scores were also significantly related to kcal consumed during the laboratory test meal when individuals were instructed to binge eat (BN groups). Data from this study add to the existing literature implicating impulsivity in the psychopathology of disorders of binge eating, including BN, and also support the use of laboratory meals as a symptom-specific measure of this trait in eating disorder populations.

Abnormalities in the EEG power spectrum in bulimia nervosa, binge‐eating disorder, and obesity: A systematic review

“…Recent evidence suggests that treatment success in BN, BED, and obesity might be impaired by general and, more importantly, food‐specific self‐regulatory deficits (e.g., Brockmeyer et al, ; Manasse et al, ; Sysko et al, ). A number of studies suggested that the recruitment of the prefrontal control circuitry is altered in these conditions, which might explain the diminished self‐regulatory abilities in several executive functions, such as impulsivity, set shifting, or inhibition (Lavagnino, Arnone, Cao, Soares, & Selvaraj, ; Steward, Menchón, Jiménez‐Murcia, Soriano‐Mas, & Fernández‐Aranda, ).…”

Relationship between three factor eating questionnaire‐restraint subscale and food intake

“…Participants were 183 individuals who participated in one of six previously published (Foerde, Steinglass, Shohamy, & Walsh, ; Gianini et al, ; Mayer, Schebendach, Bodell, Shingleton, & Walsh, ; Steinglass et al, , ; Sysko et al, ) or two ongoing eating behavior studies at the Columbia Center for Eating Disorders at the New York State Psychiatric Institute (NYSPI): 81 women and two men with AN, 30 women with BN, and 69 female and one male HC. HC were individuals with no current or prior eating disorder and included normal weight non‐dieters, as well as those who endorsed dieting, and obese individuals, as well as individuals who had lost at least 30 lbs.…”

“…Participants were 183 individuals who participated in one of six previously published (Foerde, Steinglass, Shohamy, & Walsh, 2015;Gianini et al, 2015;Mayer, Schebendach, Bodell, Shingleton, & Walsh, 2012;Steinglass et al, 2014Steinglass et al, , 2018Sysko et al, 2017) (Fairburn & Cooper, 1993) and/or Eating Disorders Assessment-5 (Sysko et al, 2015). The parent studies included the baseline assessment from two pilot interventional studies (Steinglass et al, 2014;Steinglass et al, 2018).…”

Emerging Treatments in Eating Disorders

“…Clinical studies testing this hypothesis have not yet been reported in humans and will be needed to confirm this hypothesis. Alternatively, several studies have found that elevated rates of impulsivity and behavioral disinhibition contribute to binge-eating episodes in patients with BN and BED [2][3][4][5][6]. Psychopharmacologic studies support a role for fluoxetine and lisdexamfetamine in treating…”