Remission of loss of control eating and changes in components of the metabolic syndrome

Abstract

Objective Pediatric loss of control (LOC) eating prospectively predicts the worsening of metabolic syndrome components. However, it is unknown if remission of LOC eating is associated with improvements in metabolic health. Therefore, we conducted a secondary analysis of a trial that enrolled adolescent girls with LOC eating, examining whether LOC remission (vs. persistence) at end-of-treatment was associated with changes in metabolic syndrome components at 6-month follow-up. Method One hundred three adolescent girls (age 14.5±1.7y; BMI-z 1.5±0.3; 56.3% non-Hispanic White, 24.3% non-Hispanic Black) with elevated weight (75th-97th BMI %ile) and reported LOC eating were assessed for metabolic syndrome components at baseline and again six months following the interventions. The main effects of LOC status at end-of-treatment (persistence vs. remission) on metabolic syndrome components (waist circumference, lipids, glucose, and blood pressure) at 6-month follow-up were examined, adjusting for baseline age, depressive symptoms, LOC frequency, fat mass, and height, as well as race, change in height, change in fat mass, and the baseline value of each respective component. Results Youth with LOC remission at end-of-treatment had lower glucose (83.9±6.4 vs. 86.5±5.8 mg/dL; p = .02), higher high-density lipoprotein cholesterol (50.3±11.8 vs. 44.8±11.9 mg/dL; p = .01), and lower triglycerides (84.4±46.2 vs. 96.9±53.7 mg/dL; p = .02) at 6-month follow-up compared to youth with persistent LOC, despite no baseline differences in these components. No other component significantly differed by LOC eating status (ps > .05). Discussion Reducing LOC eating in adolescent girls may have a beneficial impact on some components of the metabolic syndrome.

Do stress eating or compulsive eating influence metabolic health in a mindfulness-based weight loss intervention?

“…Given the prospective links between binge eating and worsening in metabolic health (Hudson et al, 2010), it would be logical to infer that improvements in these nonhomeostatic eating behaviors would contribute to metabolic improvements. Indeed, in a study of youth with loss of control (LOC) eating (considered a precursor to adult binge eating disorder) who were randomized to an interpersonal psychotherapy group or a health education control group, youth in both treatment arms whose LOC eating improved immediately following intervention evidenced decreases in FBG and lipids when compared to youth whose LOC persisted (Shank et al, 2018). Similarly, among adults with obesity, there is support for rapid reductions in binge eating frequency predicting greater weight loss, regardless of intervention assignment to orlistat plus cognitive–behavioral therapy or placebo plus cognitive–behavioral therapy (Grilo & Masheb, 2007).…”

Associations of sleep patterns with metabolic syndrome indices, body composition, and energy intake in children and adolescents

“…BMI percentiles and z-scores, adjusted for age and sex, were computed according to the Centers of Disease Control and Prevention growth standards, with overweight being defined as a BMI percentile of 85 th - <95 th or BMI-z of 1.0–1.64, and obesity defined as BMI percentile of ≥95 th or BMI-z >1.64 [26]. Participants had blood drawn while fasting during the second screening visit to determine triglycerides, cholesterol [total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C)], glucose, and insulin concentrations, measured by the NIH Clinical Center Department of Laboratory Medicine [27]. An index of insulin resistance, HOMA-IR, was calculated by multiplying fasting insulin (mIU/mL) by fasting glucose (mg/dL) and dividing by 405.…”

Sex differences in metabolic syndrome components in adolescent military dependents at high‐risk for adult obesity

“…In civilian samples, preliminary research suggests family-based lifestyle interventions 46 or diet and exercise interventions 47 may improve MetS components in youth with high weight. In another study, the remission of loss-of-control eating following obesity prevention programs was associated with improved glucose, HDL-C, and triglycerides at six-month follow-up, 48 suggesting that targeting loss-of-control eating may improve some MetS components. The effectiveness of these interventions, as well as other psychological and behavioral interventions, should be examined in adolescent military dependents.…”