Mood, eating attitudes, and anger in obese women with and without Binge Eating Disorder.

OBJECTIVE The aim of this study was to evaluate the anger levels and their management in obese patients. METHODS A total of 103 obese women [51 with Binge Eating Disorder (BED) and 52 without BED] were included in the study and compared to 93 healthy controls. They were assessed with the State-Trait Anger Expression Inventory (STAXI), Beck Depression Inventory (BDI), and Eating Disorder Inventory-2 (EDI-2). RESULTS The BDI score is higher in obese subjects than in controls and obese binge eaters have higher levels of depression than obese patients without BED. Differences among the three groups can be found in almost all subscales of the EDI-2, even after controlling for the variable depression (BDI). For STAXI, the only difference among the three groups, which remains significant after controlling for depression, is the tendency to express anger outside (AX-OUT), which is higher in obese binge eaters. The correlation study highlights the importance of impulsivity in the group of obese binge eaters, whereas in obese patients without BED, the tendency toward anger suppression (AX-IN) is seen. DISCUSSION Obese patients with BED might be considered a subgroup deserving greater psychiatric interest, both for the greater severity of the eating disorder and for the comorbidity with subthreshold depressive symptoms and with borderline personality traits. In obese patients without BED, eating behavior seems more correlated to the psychological functioning typical of psychosomatic disorders. Implications for treatment are discussed.

[1]  G. Caputo,et al.  Binge eating in obesity: Toward the specification of predictors , 1991 .

[2]  K. Matthews,et al.  Anger, hostility, and vesceral adipose tissue in healthy postmenopausal women , 1999 .

[3]  G. Zalsman,et al.  Internalized anger, self-control, and mastery experience in inpatient anorexic adolescents. , 2000, Journal of psychosomatic research.

[4]  Is there another binge eating disorder? A review of the literature on overeating in the absence of bulimia nervosa , 1992 .

[5]  T. Wadden,et al.  Binge eating disorder: its further validation in a multisite study. , 1993, The International journal of eating disorders.

[6]  C. Bell.  DSM-IV: Diagnostic and Statistical Manual of Mental Disorders , 1994 .

[7]  M. Clark,et al.  Binge eating, body image, depression, and self-efficacy in an obese clinical population. , 1999, Obesity research.

[8]  R R Wing,et al.  A double-blind, placebo-controlled trial of fluoxetine plus behavior modification in the treatment of obese binge-eaters and non-binge-eaters. , 1990, The American journal of psychiatry.

[9]  M. Fava,et al.  Anger attacks in eating disorders , 1995, Psychiatry Research.

[10]  R. Sansone,et al.  Obesity, borderline personality symptomatology, and body image among women in a psychiatric outpatient setting. , 2001, The International journal of eating disorders.

[11]  G. Rovera,et al.  Outcome Predictors in Anorectic Patients after 6 Months of Multimodal Treatment , 2001, Psychotherapy and Psychosomatics.

[12]  L. Aronne,et al.  Psychiatric illness in patients presenting for obesity treatment , 1992 .

[13]  M. Wiederman,et al.  The comorbidity, relationship and treatment implications of borderline personality and obesity. , 1997, Journal of psychosomatic research.

[14]  W. Linden,et al.  Well-being and morbid obesity in women: a controlled therapy evaluation. , 1998, The International journal of eating disorders.

[15]  W. Agras,et al.  Eating and general psychopathology in a sample of Caucasian and ethnic minority subjects. , 1997, The International journal of eating disorders.

[16]  P. Garfinkel,et al.  Handbook of treatment for eating disorders , 1997 .

[17]  X. Pi-Sunyer.  The NAASO position paper on approval and use of drugs to treat obesity. , 1995, Obesity research.

[18]  G. Groth-Marnat.  Handbook of Psychological Assessment , 2016 .

[19]  M. de Zwaan,et al.  Eating related and general psychopathology in obese females with binge eating disorder. , 1994, The International journal of eating disorders.

[20]  G. Waller,et al.  Anger and bulimic psychopathology among nonclinical women. , 2000, The International journal of eating disorders.

[21]  G. Rovera,et al.  Dropout from Brief Psychotherapy in Anorexia nervosa , 2002, Psychotherapy and Psychosomatics.

[22]  P. Leombruni,et al.  Anger and personality in eating disorders. , 2001, Journal of psychosomatic research.

[23]  D. Labarthe,et al.  Anger expression, body fat, and blood pressure in adolescents: Project HeartBeat! , 2001, American journal of human biology : the official journal of the Human Biology Council.

[24]  J H Crowther,et al.  Personality and eating habit variables as predictors of severity of binge eating and weight. , 1983, Addictive behaviors.

[25]  M. de Zwaan,et al.  Alexithymia, obesity, and binge eating disorder. , 1995, The International journal of eating disorders.

[26]  R. Spitzer,et al.  Association of binge eating disorder and psychiatric comorbidity in obese subjects. , 1993, The American journal of psychiatry.

[27]  Louis F. Martin.  The Biopsychosocial Characteristics of People Seeking Treatment for Obesity , 1999, Obesity surgery.

[28]  S. Garattini.  Biological actions of drugs affecting serotonin and eating. , 1995, Obesity research.

[29]  C. Stoney,et al.  Plasma homocysteine concentrations are positively associated with hostility and anger. , 2000, Life sciences.

[30]  R. Fleet,et al.  Anger, negative emotions, and cardiovascular reactivity during interpersonal conflict in women. , 2001, Journal of psychosomatic research.

[31]  J. Geller,et al.  Inhibited expression of negative emotions and interpersonal orientation in anorexia nervosa. , 2000, The International journal of eating disorders.

[32]  G. Bray,et al.  Pathophysiology of obesity. , 1992, The American journal of clinical nutrition.

[33]  P J Mills,et al.  Anger suppression: its relationship to β-adrenergic receptor sensitivity and stress-induced changes in blood pressure , 1993, Psychological Medicine.

[34]  S. Yanovski,et al.  Obesity: what mental health professionals need to know. , 2000, The American journal of psychiatry.

[35]  G. Groth-Marnat,et al.  Handbook of psychological assessment, 4th ed. , 2003 .

[36]  M. Marcus,et al.  Characterization of eating disordered behavior in obese binge eaters , 1992 .

[37]  S. Wonderlich,et al.  The neglected link between eating disturbances and aggressive behavior in girls. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[38]  M. Gladis,et al.  Behavioral treatment of obese binge eaters: do they need different care? , 1998, Journal of Psychosomatic Research.

[39]  P. Santonastaso,et al.  Different types of self-injurious behavior in bulimia nervosa. , 1999, Comprehensive psychiatry.

[40]  W. Agras,et al.  Obesity, binge eating and psychopathology: are they related? , 1994, The International journal of eating disorders.

[41]  J. Treasure,et al.  Patterns of punitiveness in women with eating disorders. , 1995, The International journal of eating disorders.

[42]  C. Grilo,et al.  Teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in binge eating disorder. , 2000, Obesity research.

[43]  N. Andreasen,et al.  Simultaneous Tests of Many Hypotheses in Exploratory Research , 1982, The Journal of nervous and mental disease.

[44]  G. Fava,et al.  Psychosomatic Medicine: Emerging Trends and Perspectives , 2000, Psychotherapy and Psychosomatics.

[45]  G. Rovera,et al.  Temperament and character in obese women with and without binge eating disorder. , 2002, Comprehensive psychiatry.

[46]  W. Agras,et al.  Do emotional states influence binge eating in the obese? , 1996, The International journal of eating disorders.

[47]  W. Agras,et al.  Perfectionism in women with binge eating disorder. , 2001, The International journal of eating disorders.

[48]  J. Halford,et al.  Serotonin, eating behavior, and fat intake. , 1995, Obesity research.

[49]  M. de Zwaan,et al.  Onset of binge eating and dieting in overweight women: implications for etiology, associated features and treatment. , 1998, Journal of psychosomatic research.

[50]  C Henry,et al.  Affective instability and impulsivity in borderline personality and bipolar II disorders: similarities and differences. , 2001, Journal of psychiatric research.

[51]  J. Polivy,et al.  Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. , 1983 .