Subtyping children and adolescents with loss of control eating by negative affect and dietary restraint

Abstract

Objective-Research suggests that subtyping adults with binge eating disorders by dietary restraint and negative affect predicts comorbid psychopathology, binge eating severity, and treatment outcome. Little research has explored the validity and clinical utility of subtyping youth along these dimensions.Method-Children (aged 8-18y) reporting loss of control eating (n=159) were characterized based upon measures of dietary restraint and negative affect using cluster analysis, and then compared regarding disordered eating attitudes and behaviors, and parent-reported behavior problems.Results-Robust subtypes characterized by dietary restraint (n=114; 71.7%) and dietary restraint/ high negative affect (n=45; 28.3%) emerged. Compared to the former group, the dietary restraint/ high negative affect subtype evidenced increased shape and weight concerns, more frequent binge eating episodes, and higher rates of parent-reported problems (all ps<.05). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conclusion-Similar to findings from the adult literature, the presence of negative affect may mark a more severe variant of loss of control eating in youth. Future research should explore the impact of dietary restraint/negative affect subtypes on psychiatric functioning, body weight, and treatment outcome. NIH Public Access

Bulimia nervosa with history of anorexia nervosa: Could the clinical subtype of anorexia have implications for clinical status and treatment response?

“…These results are in accordance with the observation that ANBP patients had a higher rate of recovery than ANR patients, 36 which will still exist after the crossover to BN, and also with the fact that the combination of dieting and depressive symptoms, which were less severe in BN/AN1 BP patients than in the other two groups, are the clinical markers for a more severe variant of BN. 37,38 Several studies have suggested that severe restraint and affective disturbance are associated with greater eating-related attitudinal psychopathology and psychological symptomatology, [39][40][41][42] and we believe that this clinical observation is applicable to our results. It is also possible that impulsivity, which was higher in our BN/AN1 R patients than in our BN/AN1 BP patients, might be related to the poorer outcome observed in the former, as it has been widely demonstrated that impulsivity is a strong predictor of bad outcome in BN 12,34,[43][44][45][46][47][48] In conclusion, it has been suggested that studies should be designed to determine whether the diagnosis of AN or certain aspects of AN may be capable of determining clinical characteristics or outcome in patients with BN.…”

A Prospective Study of Overeating, Binge Eating, and Depressive Symptoms Among Adolescent and Young Adult Women

“…31 These results suggest that both dietary restraint and depressive symptoms (negative affect) predict incident binge-eating among girls aged 10 to 14 years and thereby provide further support for the validity of the dual-pathway model of binge eating. 31,33,35,36 …”

Serum leptin and loss of control eating in children and adolescents

“…Studies suggest few differences between youth who describe LOC episodes characterized by the consumption of an “unambiguously large” amount of food versus an amount of food not considered unambiguously large, with respect to weight concerns, depressive symptoms, and disordered eating attitudes. 47, 48 Additionally, some studies find that youth who report LOC do not necessarily consume more calories during a test meal than youth who do not report LOC, nor do they self-report consuming more calories during an interview. 49 Rather, youth with reported LOC may consume meals characterized by consumption of a greater proportion of calories from carbohydrates, including snacks and desserts, and less from protein.…”