A biobehavioral circadian model of restrictive eating and binge eating

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ObjectiveCircadian rhythm disruptions are associated with binge eating, can be causal of negative mood, and may be corrected with bright light exposure. A subtype of individuals with binge‐spectrum eating disorders are characterized by combined high dietary restraint and negative affect. These individuals have higher eating disorder psychopathology and poorer treatment response. We aimed to test the targeted effects of morning bright light exposure on individuals with binge‐spectrum eating disorders, hypothesizing significant reductions in binge eating for those characterized by high dietary restraint and negative affect.MethodsParticipants (N = 34 females with binge‐eating disorder and bulimia nervosa) used a morning bright light and normal light for 10 consecutive days each, in randomized order. They completed the Change in Eating Disorder Symptoms (CHEDS) scale at baseline, day 12 (when they switched lamps), and day 22. We conducted moderation analyses, clustering data by person, controlling for order, and examining the effect of light condition on binge eating according to baseline restraint and negative affect.ResultsAt high levels of combined dietary restraint and negative affect, participants experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. There were no changes in restrictive eating, body preoccupation, body dissatisfaction, or body checking following exposure to morning bright light for these individuals.DiscussionThese findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult to treat restraint/negative affect subtype.Public SignificanceAt high levels of combined dietary restraint and negative affect, participants with binge‐spectrum eating disorders experienced a reduction in binge eating and food preoccupation following exposure to morning bright light. These findings suggest that morning bright light may be a useful adjunct to empirically supported eating disorder treatments that target binge eating, especially for individuals characterized by the difficult‐to‐treat restraint/negative affect subtype.

Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Responses to bright light exposure in individuals with binge‐spectrum eating disorders characterized by high dietary restraint and negative affect

Kambanis,

Bottera,

De Young

2023

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“…Although the effects were small, participants in the current sample were most likely to report loss of control only eating episodes in the morning and early afternoon (i.e., before 2:00 p.m.), while binge‐eating episodes were most commonly reported during the afternoon and evening. The predominance of loss of control only episodes earlier in the day may reflect the fact that many individuals with BED attempt to restrict their intake during this time period (often due to reduced appetite and a desire to limit caloric intake) (de Young & Bottera, 2022). It is therefore possible that this increased dietary restraint contributes to individuals with BED feeling out of control, even when consuming small or “normal” amounts of food.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the robust diurnal patterns of binge eating observed across AN, BN, and BED support research suggesting that disrupted circadian rhythms may contribute to the onset and maintenance of binge‐eating behavior. Therefore, it is possible that supplementing traditional treatments with intervention techniques specifically designed to regulate diurnal rhythms may support enhanced treatment efficacy, though additional research is needed to evaluate this possibility (de Young & Bottera, 2022).…”

Section: Discussionmentioning

confidence: 99%

Time‐of‐day and day‐of‐week patterns of binge eating and relevant psychological vulnerabilities in binge‐eating disorder

Forester,

Schaefer,

Dodd

et al. 2023

ObjectiveThe present study sought to characterize the temporal patterns of binge eating and theorized maintenance factors among individuals with binge‐eating disorder (BED).MethodEcological momentary assessment of 112 individuals and mixed‐effects models were used to characterize the within‐ and between‐day temporal patterns of eating behaviors (binge eating, loss of control only eating, and overeating only), positive and negative affect, emotion regulation difficulty, and food craving.ResultsRisk for binge eating and overeating only was highest around 5:30 p.m., with additional binge‐eating peaks around 12:30 and 11:00 p.m. In contrast, loss of control eating without overeating was more likely to occur before 2:00 p.m. Risk for binge eating, loss of control only eating, and overeating only did not vary across days in the week. There was no consistent pattern of change in negative affect throughout the day, but it decreased slightly on the weekend. Positive affect showed a decrease in the evenings and a smaller decrease on the weekend. The within‐day patterns of food craving, and to some extent emotion regulation difficulty, resembled the pattern of binge eating, with peaks around meal times and at the end of the night.DiscussionIndividuals with BED appear most susceptible to binge‐eating around dinner time, with heightened risk also observed around lunch time and late evening, though the effects were generally small. These patterns appear to most strongly mimic fluctuations in craving and emotion dysregulation, although future research is needed to test the temporal relationships between these experiences directly.Public SignificanceIt is unknown which times of the day and days of the week individuals with binge‐eating disorder are most at risk for binge eating. By assessing binge‐eating behaviors in the natural environment across the week, we found that individuals are most likely to binge in the evening, which corresponds to the times when they experience the strongest food craving and difficulty with regulating emotions.

The Integration of Sleep Research Into Eating Disorders Research: Recommendations and Best Practices

Irish,

Bottera,

Manasse

et al. 2024

ObjectiveSleep disturbance is common among individuals with eating disorders (EDs), with approximately 50% of patients with EDs reporting sleep disturbance. Sleep problems may promote, exacerbate, or maintain ED symptoms through a variety of hypothesized mechanisms, such as impaired executive function, increased negative affect, and disruptions to appetitive rhythms. Although research investigating the role of sleep in EDs is growing, the current literature suffers from methodological limitations and inconsistencies, which reduce our ability to translate findings to improve clinical practice. The purpose of this forum is to propose a coordinated approach to more seamlessly integrate sleep research into ED research with particular emphasis on best practices in the definition and assessment of sleep characteristics.MethodsIn this article, we will describe the current status of sleep‐related research and relevant gaps within ED research practices, define key sleep characteristics, and review common assessment strategies for these sleep characteristics. Throughout the forum, we also discuss study design considerations and recommendations for future research aiming to integrate sleep research into ED research.Results/DiscussionGiven the potential role of sleep in ED maintenance and treatment, it is important to build upon preliminary findings using a rigorous and systematic approach. Moving forward as a field necessitates a common lens through which future research on sleep and EDs may be conducted, communicated, and evaluated.