Regurgitation and reingestion in captive gorillas: Description and intervention

Direct observation of regurgitation and reingestion (r/r) of captive gorillas was used to describe and catalog this behavior and thus lay the groundwork for possible intervention in the r/r cycle. Analysis of questionnaires regarding 117 gorillas at 17 zoos suggests that social deficits during early development contribute to the occurrence of r/r later in life. Wild-caught and captive-born, hand-reared gorillas show higher incidence of r/r than that of mother-reared infants. R/r increases the daily ingestion time. Feeding browse decreases r/r and increases time spent feeding from about 11% of the day to 27% of the day.     

Altered brain-derived neurotrophic factor blood levels and gene variability are associated with anorexia and bulimia

Murine models and association studies in eating disorder (ED) patients have shown a role for the brain-derived neurotrophic factor (BDNF) in eating behavior. Some studies have shown association of BDNF -270C/T single-nucleotide polymorphism (SNP) with bulimia nervosa (BN), while BDNF Val66Met variant has been shown to be associated with both BN and anorexia nervosa (AN). To further test the role of this neurotrophin in humans, we screened 36 SNPs in the BDNF gene and tested for their association with ED and plasma BDNF levels as a quantitative trait. We performed a family-based association study in 106 ED nuclear families and analyzed BDNF blood levels in 110 ED patients and in 50 sib pairs discordant for ED. The rs7124442T/rs11030102C/rs11030119G haplotype was found associated with high BDNF levels (mean BDNF TCG haplotype carriers = 43.6 ng/ml vs. mean others 23.0 ng/ml, P = 0.016) and BN (Z = 2.64; P recessive = 0.008), and the rs7934165A/270T haplotype was associated with AN (Z =-2.64; P additive = 0.008). The comparison of BDNF levels in 50 ED discordant sib pairs showed elevated plasma BDNF levels for the ED group (mean controls = 41.0 vs. mean ED = 52.7; P = 0.004). Our data strongly suggest that altered BDNF levels modulated by BDNF gene variability are associated with the susceptibility to ED, providing physiological evidence that BDNF plays a role in the development of AN and BN, and strongly arguing for its involvement in eating behavior and body weight regulation.     

Effects of chronic brofaromine administration on biogenic amines including sulphatoxymelatonin and acid metabolites in patients with bulimia nervosa

Brofaromine, a selective and reversible inhibitor of monoamine oxidase-A (MAO-A) was given to 19 women while 17 received placebo for 8 weeks. All met DSM III-R criteria for bulimia nervosa, a psychiatric disorder in which uncontrolled overeating episodes are accompanied by purging activities and extreme concerns about body shape and weight. The following indices were measured: plasma and urinary phenylacetic acid (PAA), homovanillic acid (HVA), vanillylmandellic acid (VMA); plasma tryptamine (T), phenylethylamine (PE), and 5-hydroxyindoleacetic acid (5-HIAA) and urinary 6-sulphatoxymelatonin (aMT6s). PE levels remained the same but T showed a trend toward elevation over time. Twenty-four hour levels of urinary aMT6s in BN patients were higher at week 4 when compared to baseline and week 8. There was a significant reduction in plasma VMA and HVA over time during treatment with brofaromine and both plasma HVA and VMA were significantly lower for the brofaromine group compared to placebo at week 4. Plasma 5-HIAA was significantly higher for the brofaromine group after 8 weeks when compared to placebo. Urinary VMA decreased significantly from baseline to week 4 with a partial elevation at 8 weeks. Urinary VMA was also significantly lower in patients on brofaromine at week 4. This study verifies that brofaromine complies with predicted MAO-A inhibiting patterns in a clinical population.     

Binge Eating Behavior in Patients with Eating Disorders

The purpose of this study was to determine whether the objectively observed binge eating behavior of obese subjects meeting the proposed DSM-IV criteria for binge eating disorder would be similar to that observed in patients with bulimia nervosa. Non-obese patients with bulimia nervosa (BN), obese subjects with binge eating disorder (BED), obese and non-obese women without eating disorders were each instructed to binge eat single- and multiple-item meals. In the multiple-item meal, the obese subjects with BED ate significantly more (1515 kcal) than obese subjects without BED (1115 kcal), but they ate less than the normal-weight bulimic patients (2680 kcal). The non-obese controls ate amounts similar to the obese non-binge-eating-disordered group (1093 and 1115.2 kcal, respectively). In the single-item meal, consisting of ice cream, patients with BN ate significantly more than any other group (1307 kcal), while obese subjects with or without binge-eating disorder ate significantly more (762 kcal) than non-obese controls (308 kcal). This study has demonstrated that although both BN and BED are characterized by recurrent episodes of binge eating, quantitatively there appear to be differences between the eating disturbances in the two disorders. Because single- and multiple-item meals differ in external cues, these results also suggest that the obese subjects with BED may be disinhibited by external cues, while obese subjects without BED may be inhibited by external cues.     

Focus: Addiction: Back by Popular Demand: A Narrative Review on the History of Food Addiction Research

In recent years, the concept of food addiction has gained more and more popularity. This approach acknowledges the apparent parallels between substance use disorders and overeating of highly palatable, high-caloric foods. Part of this discussion includes that “hyperpalatable” foods may have an addictive potential because of increased potency due to certain nutrients or additives. Although this idea seems to be relatively new, research on food addiction actually encompasses several decades, a fact that often remains unrecognized. Scientific use of the term addiction in reference to chocolate even dates back to the 19th century. In the 20th century, food addiction research underwent several paradigm shifts, which include changing foci on anorexia nervosa, bulimia nervosa, obesity, or binge eating disorder. Thus, the purpose of this review is to describe the history and state of the art of food addiction research and to demonstrate its development and refinement of definitions and methodologies.     

Racial/Ethnic and Gender Differences in Concern with Weight and in Bulimic Behaviors Among Adolescents

FIELD, ALISON E, GRAHAM A COLDITZ, KAREN E PETERSON. Racial/ethnic and gender differences in concern with weight and in bulimic behaviors among adolescents. This study examined cross-sectional gender and racial/ethnic differences in bulimic behaviors among adolescents. Subjects were 704 male and 621 female students at a large urban public high school in the Northeast. Approximately 61% of the girls and 43% of the boys reported trying to lose weight or maintain their current weight; 2.0% of the students reported using laxatives or vomiting to control their weight. The use of these behaviors to control weight was only slightly more common among girls than boys (2.7% vs. 1.4%,p=0.1). Although more black than white girls used laxatives or vomiting to control weight (odds ratio [OR]=11.9, 95% confidence interval [CI] 1.5–95.3), there were no racial/ethnic differences in these behaviors among boys. However, Hispanic boys were twice as likely as white boys to binge eat at least monthly (OR=2.0, 95% CI 1.1–3.6). Our results suggest that bulimic behaviors affect male and female adolescents from a variety of racial/ethnic backgrounds. In addition, in contrast to the large gender differences in the prevalence of dieting and binge eating, more modest differences were documented in the prevalence of using vomiting and laxatives to control weight.     

Integrated circuits and molecular components for stress and feeding: implications for eating disorders

Eating disorders are complex brain disorders that afflict millions of individuals worldwide. The etiology of these diseases is not fully understood, but a growing body of literature suggests that stress and anxiety may play a critical role in their development. As our understanding of the genetic and environmental factors that contribute to disease in clinical populations like anorexia nervosa, bulimia nervosa and binge eating disorder continue to grow, neuroscientists are using animal models to understand the neurobiology of stress and feeding. We hypothesize that eating disorder clinical phenotypes may result from stress‐induced maladaptive alterations in neural circuits that regulate feeding, and that these circuits can be neurochemically isolated using animal model of eating disorders.     

Association of CNR1 and FAAH endocannabinoid gene polymorphisms with anorexia nervosa and bulimia nervosa: evidence for synergistic effects

Endocannabinoids modulate eating behavior; hence, endocannabinoid genes may contribute to the biological vulnerability to eating disorders. The rs1049353 (1359 G/A) single nucleotide polymorphism (SNP) of the gene coding the endocannabinoid CB1 receptor ( CNR1 ) and the rs324420 (cDNA 385C to A) SNP of the gene coding fatty acid amide hydrolase (FAAH), the major degrading enzyme of endocannabinoids, have been suggested to have functional effects on mature proteins. Therefore, we explored the possibility that those SNPs were associated to anorexia nervosa and/or bulimia nervosa. The distributions of the CNR1 1359 G/A SNP and of the FAAH cDNA 385C to A SNP were investigated in 134 patients with anorexia nervosa, 180 patients with bulimia nervosa and 148 normal weight healthy controls. Additive effects of the two SNPs in the genetic susceptibility to anorexia nervosa and bulimia nervosa were also tested. As compared to healthy controls, anorexic and bulimic patients showed significantly higher frequencies of the AG genotype and the A allele of the CNR1 1359 G/A SNP. Similarly, the AC genotype and the A allele of the FAAH cDNA 385C to A SNP were significantly more frequent in anorexic and bulimic individuals. A synergistic effect of the two SNPs was evident in anorexia nervosa but not in bulimia nervosa. Present findings show for the first time that the CNR1 1359 G/A SNP and the FAAH cDNA 385C to A SNP are significantly associated to anorexia nervosa and bulimia nervosa, and demonstrate a synergistic effect of the two SNPs in anorexia nervosa.     

Binge Eating Disorder Affects Outcome of Comprehensive Very-Low-Calorie Diet Treatment

To determine the effects of binge eating disorder (BED) on weight loss and maintenance in women undergoing treatment for obesity, we studied the weight changes of 38 women (body mass index >30 kg/m²), 21 of whom met proposed criteria for BED and 17 of whom reported few problems with binge eating, during and after a 26-week comprehensive very-low-calorie diet (VLCD) treatment program. All 17 subjects without and 16/21 subjects with BED returned for four follow-up visits over 12 months (p=0.05). While a similar proportion of subjects with and without BED reported absolute adherence to both the modified fast and refeeding, those with BED showed a significantly different distribution in energy intake from those without BED, with fewer small and more large lapses among those who deviated from the diet (p<0.05). There was no significant difference in mean weight loss over the 26 weeks of treatment, but subjects with BED showed significantly diminished weight loss during the middle third of treatment (p<0.05). Black subjects, regardless of the presence of BED, lost significantly less weight during treatment than white subjects (p<0.005). Although there was no significant difference in mean weight loss at any of the four follow-up visits between subjects with and without BED, 25% of subjects with BED had regained >50% of their lost weight by three-month follow-up, vs. no subjects without the disorder (p<0.05). One year after completing treatment, approximately half of BED (+) and BED (-) subjects had a good outcome, maintaining a weight loss ≥10% of initial body weight. However, 35% of subjects with BED, and none of the subjects without BED, had a poor outcome (p<0.05). We conclude that many individuals with BED will respond well to a medically supervised comprehensive VLCD program, attaining medically significant weight loss. However, this subgroup appears to be at risk for early major regain of lost weight and for poor outcome one year following weight-loss treatment.     

Binge-Eating Disorder in Brazilian Women on a Weight-Loss Program

Objective: To examine binge-eating disorder (BED) and its association with obesity, weight patterns, and psychopathology in a Brazilian sample of female participants of a weight-loss program in São Paulo, Brazil. Research Methods and Procedures: Two hundred and seventeen overweight (body mass index ≥ 25 kg/m²) women, ages 15 to 59 years, enrolled in the Weight Watchers Program were recruited for the study at a program branch meeting after completing the Questionnaire on Eating and Weight Patterns–Revised, Beck Depression Inventory, and the Toronto Alexithymia Scale-20. Participants were categorized into four groups: those who met questionnaire criteria for BED, those who met questionnaire criteria for bulimia nervosa (BN), those that reported binge eating but did not meet all the criteria for any eating disorder (BE), and those with no eating disorder symptoms (No ED). Groups were compared on measures of weight, depressive symptoms, and alexithymia. Results: Binge eating was frequently reported by women in this study (BED, 16.1%; BN, 4.6%; BE, 22.6%). BED women had significantly higher body mass index, greater highest weight ever, and more frequent weight cycling than the No ED group. BED women also reported more depressive symptoms than BE and No ED women, and were more alexithymic than the No ED group. BE women presented more frequent weigh cycling and were also more depressed and alexithymic than the No ED group. Discussion: BED is not uncommon in overweight Brazilian women, and similar to North American and European samples, it is associated with overweight and higher levels of psychopathology in this population.