Obesity is a major health issue in the United States. It has been suggested that addictive-like tendencies toward foods, especially highly processed foods, contributes to this epidemic. If so, interventions used to treat substance-use disorders may be effective for treating overweight/obese patients with food addiction (FA; based on the Yale Food Addiction Scale, version 2.0). This pilot study evaluated four interventions, selected because of their effectiveness in the treatment of substance-use disorders [motivational interviewing (MI), pharmacotherapy (P; naltrexone-bupropion), MI with pharmacotherapy (MI+P), information control (IC; diet and physical activity instruction)], in overweight/obese individuals with and without FA (FA+ and FA-, respectively). Here we report the baseline (pre-intervention) characteristics of FA+ and FA-participants based on their intake documents. FA was fairly common in this population (37.1% of those screened). Most participants experienced depression (81.9%, FA+ 94.3%, FA-73.0%) and anxiety (60.2%, FA+ 74.3%, FA-50%) with greater prevalence (p<.01) and severity in those who were FA+. Many participants screened positive for binge eating (42.2%, FA+ 65.7%, FA-25.0%) and to a lesser extent PTSD (18.1%, FA+ 37.1%, FA-4.2%), with greater prevalence among those who were FA+ (p<.01). Drug abuse (20.5%) and mood disorder (8.4%) were relatively uncommon and prevalence did not differ between FA phenotypes (p>.05). The FA construct identified a distinctive subset of overweight/obese individuals. Differences in baseline characteristics suggest that FA+ and FA-individuals may differ in their response to interventions and the types of support they need to achieve their weight/body fat loss goals.

Objective assessments of concussion recovery are crucial for facilitating effective clinical management. However, predictive tools for determining adolescent concussion outcomes are currently limited. Research suggests that heart rate variability (HRV) represents an indirect and objective marker of central and peripheral nervous system integration. Therefore, it may effectively identify underlying deficits and reliably predict the symptomology following concussion. Thus, the present study sought to evaluate the relationship between HRV and adolescent concussion outcomes. Furthermore, we sought to examine its predictive value for assessing outcomes. Fifty-five concussed adolescents (12–17 years old) recruited from a local sports medicine clinic were assessed during the initial subacute evaluation (within 15 days postinjury) and instructed to follow up for a post-acute evaluation. Self-reported clinical and depressive symptoms, neurobehavioral function, and cognitive performance were collected at each timepoint. Short-term HRV metrics via photoplethysmography were obtained under resting conditions and physiological stress. Regression analyses demonstrated significant associations between HRV metrics, clinical symptoms, neurobehavioral function, and cognitive performance at the subacute evaluation. Importantly, the analyses illustrated that subacute HRV metrics significantly predicted diminished post-acute neurobehavioral function and cognitive performance. These findings indicate that subacute HRV metrics may serve as a viable predictive biomarker for identifying underlying neurological dysfunction following concussion and predict late cognitive outcomes.

Objectives: Empirical evidence is growing that addictive-like tendencies toward foods may contribute to obesity. This pilot study evaluated interventions used to treat addictive disorders for the treatment of obesity in individuals with and without food addiction (FA). FA and depression were common in the study population at baseline, with greater prevalence and severity of depression in those with FA. This secondary analysis evaluated whether prevalence and/or severity of FA and depression changed with intervention. Methods: Participants within each obesity phenotype (FA+, FA-) were randomly assigned to treatment groups [motivational interviewing, pharmacotherapy (naltrexone-bupropion), motivational interviewing with pharmacotherapy, information control]. Interventions were delivered following data collection at baseline, 1, 2, 3, and 4 weeks and 2, 3, 4, 5, and 6 months. FA and depression were assessed at baseline and 6 months using the Yale Food Addiction Scale and Patient Health Questionnaire-9, respectively. Results: Prevalence and severity of FA declined between baseline and 6 months (P < .001). The decline in symptoms was greater among those who were FA+ than among those who were FA-(P < .001), reflecting that those who were FA+ had higher symptom totals at baseline. Depression scores and severity also declined between baseline and 6 months in both obesity phenotypes (P < .001). Conclusion: Both FA and depression were common in this study population and may contribute to obesity and/or complicate its treatment. That interventions used to treat addictive disorders lessened the prevalence and severity of both FA and depression is promising for the treatment of obesity.

Evidence suggests that factors associated with a family history of neurodegenerative disease (fhNDD) may influence outcomes following a concussion. However, the relevance of these findings in adolescent populations has not been fully explored. Therefore, the present study sought to evaluate the relationship between fhNDD and neurological outcomes following an adolescent concussion. Data from a local pediatric concussion clinic were used to compare adolescents with (n = 22) and without (n = 44) an fhNDD. Clinical symptom burden, emotional health, cardio-autonomic function, and cognitive performance were assessed at initial (~2 weeks) and follow-up (~5 weeks) post-injury evaluations. Cardio-autonomic function was assessed at rest and during isometric handgrip contraction (IHGC). Results indicated no significant group differences in emotional health or cognitive performance. Across evaluations, those with an fhNDD exhibited greater somatic symptom severity, alterations in HRV at rest, and early blunted cardio-autonomic reactivity during IHGC compared to those without an fhNDD. These findings suggest that positive fhNDD is negatively associated with clinical symptomology and cardio-autonomic functioning following an adolescent concussion. Further, these findings encourage clinicians to utilize a comprehensive neurological evaluation to monitor concussion recovery. Future studies should look into exploring the role of specific neurodegenerative processes and conditions on concussion outcomes in adolescents.

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