Oliva Rosella Euro Weight Loss-2015 Frankfurt, Germany August 18 – 20, 2015

OBESITY THE RELATIONSHIP BETWEEN BINGE EATING DISORDER AND FOOD ADDICTION

ACKNOWLEDGEMENTS  Dr. Monica Baiano – Centre for the treatment of Eating Disorders of Portogruaro (VE), Italy  Prof. Nazario Melchionda – Past President of the Italian Society for the Study of Eating Disorders (SIS.DCA)  Outpatient Service for the treatment of Eating Disorders Mestre (VE), Italy Rossella Oliva - Euro Weight Loss 2015

BINGE EATING DISORDER (BED) Episodes of binge-eating (at least once a week for 3 months)  sense of lack of control  marked distress  Sense of guilt  NO compensatory behaviors. DSM 5 (APA, 2013) Rossella Oliva - Euro Weight Loss 2015

“Some individuals with disorders described in this chapter report EATING-RELATED SYMPTOMS RESEMBLING THOSE TYPICALLY ENDORSED BY INDIVIDUALS WITH SUBSTANCE-USE DISORDERS, such as strong craving and patterns of compulsive use (…)” (DSM-5, p 329) Similarities between the behavioral indicators of addiction and Binge Eating Disorder (Gearhardt et al, 2011) Rossella Oliva - Euro Weight Loss 2015

WHAT IS AN ADDICTION? A chronic relapsing disorder characterised by:  Compulsion to seek and take the drug  Loss of control in limiting intake  Emergence of a negative emotional state (dysphoria, anxiety, irritability) (George Koob, 1947 – present) Rossella Oliva - Euro Weight Loss 2015

BED & ADDICTION Behavioral and biological overlaps between eating and addictive disorders  Loss of control  Unsuccessful efforts to cut down  A great deal of time spent thinking about the substance or engaging in the behavior  Continuing the behavior despite related consequences  Changes in social, occupational or recreational activities  Withdrawal and Tolerance symptoms Rossella Oliva - Euro Weight Loss 2015

HYPOTHESIS 1) Food addiction as a causal factor for chronic overeating 2) Food addiction as a valid phenotype of obesity Rossella Oliva - Euro Weight Loss 2015

BED/FOOD ADDICTION/OBESITY OBESITY BED FA OBESITY FABED OBESITY BED FA Rossella Oliva - Euro Weight Loss 2015

OVERCOMING HETEROGENEOUS DEFINITIONS Rossella Oliva - Euro Weight Loss 2015

YALE FOOD ADDICTION SCALE (YFAS) 1. Substance taken in larger amount and for longer period than intended. 2. Persistent desire or repeated unsuccessful attempt to quit. 3. Much time/activity to obtain, use, recover, 4. Important social, occupational, or recreation activities given up or reduced. 5. Use continues despite knowledge of adverse consequences (e.g., failure to fulfill role obligation, use when physically hazardous). 6. Tolerance (marked increase in amount; marked decrease in effect). 7. Characteristic withdrawal symptoms; substance taken to relieve withdrawal. Rossella Oliva - Euro Weight Loss 2015

81 obese patients with a diagnosis of BED -57% BED and FA -43% BED 1.BED and FA are related but do not totally overlap 2.FA is associated with higher levels of depression, negative affect and eating disorders psychopathology

THE RESEARCH Rossella Oliva - Euro Weight Loss 2015

OBJECTIVE Rossella Oliva - Euro Weight Loss 2015

PARTICIPANTS  Ninety-four obese treatment-seeking patients NAGE (M ± DS)BMI (M ± DS) Men2146,3 ± 12,835,7 ± 6,5 Women7339 ± 13,531,6 ± 8,3 Total9440,4 ± 13,832,6 ± 8,1 Rossella Oliva - Euro Weight Loss 2015

MATERIALS & METHODS  Yale Food Addiction Scale, YFAS (Gearhardt et al, 2009)  Binge Eating Scale, BES (Gormally et al, 1982)  Three Factor Eating Questionnaire, TFEQ (Stunkard et al, 1985)  Beck Depression Inventory, BDI (Beck et al, 1996) Rossella Oliva - Euro Weight Loss 2015

MATERIALS & METHODS Statistical Package for Social Science – SPSS (Levesque et al, 2007)  Descriptive statistics  Correlation between the scoring of the YFAS and: 1. Beck Depression Inventory (BDI) 2. Binge Eating Scale (BES) 3. Three Factor Questionnaire (TFEQ)  Observed Frequencies (YFAS and BES) Rossella Oliva - Euro Weight Loss 2015

RESULTS Rossella Oliva - Euro Weight Loss 2015

CORRELATIONS YFAS Symptom BES0.68*(,000) BDI0,48* (,000) TFEQ Disinhibition0,5* (,000) TFEQ Hunger0,78* (,000) TFEQ Restriction-,09 NS BMI,01 NS * Correlation is significant at the 0,01 level (2-tailed) Rossella Oliva - Euro Weight Loss 2015

OBSERVED FREQUENCIES YFAS (+)YFAS (-) BES (+) 35 (37%)8 (9%) BES (-)18 (19%) 33 (35%) Rossella Oliva - Euro Weight Loss 2015

y= 0,1273x + 1,0968 R 2 = 0,4344* Rossella Oliva - Euro Weight Loss 2015

CONCLUSIONS  Binge eating disorder (bed) and ‘food addiction’ are related but do not totally overlap.  Individuals with clinically relevant disordered eating that would not meet BED criteria, but could possibly result in obesity, may be captured under an addiction framework. OBESITY FA BED Rossella Oliva - Euro Weight Loss 2015

FUTURE DIRECTIONS “Examining the neural correlates of the different endophenotypes may enrich our understanding of the biobehavioral mechanisms of appetite and addiction” (Carnell et al, 2013)  Important clinical implication for the optimization of the treatment and the empirical exploration of BED – FA – OBESITY  Incorporation of eating and addiction assessments like the BES or the YFAS into studies of Obesity and Eating disorders and clinical practice could have important implications. Rossella Oliva - Euro Weight Loss 2015

THANK YOU FOR YOUR ATTENTION Rossella Oliva Rossella Oliva - Euro Weight Loss 2015

BINGE EATING MOOD DYSREGU LATION IMPULSIVITYBMI LACK OF CONTROL RESTRICTION FOOD ADDICTION BINGE EATING DISORDER Rossella Oliva - Euro Weight Loss 2015

Euro Weight Loss – 2016 website: Meet the eminent gathering once again at Euro Weight Loss-2016 Vienna, Austria September 19-21, 2016