Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity

Niclosamide is a well-known anthelminthic drug that exert its effects at least in part through induction of mitochondrial uncoupling. The cycling of mitochondrial proton plays an essential role in regulation of basal metabolic rate, so modulation of mitochondrial uncoupling may be helpful approach to fight obesity. To assess the anti-obesity effects of niclosamide on mice with induced obesity. Thirty male Albino mice, 8–10 weeks old, were divided randomly and equally in to three groups; Group 1 fed with standard diet, whereas both Groups 2 and 3 were fed with high fat diet (HFD). At 10 weeks, the studied groups continue in the same type of diet as before for another 4 weeks, but additionally both of Group1 and 2 received placebo treatment as normal control and high fat diet control respectively, whereas Group 3 received oral niclosamide (140 mg/kg/day) as treatment group. The anti-obesity effects of niclosamide were evaluated by testing its effects on food intake, bodyweight, glycemic indices, and lipid profile. It was found that administration of niclosamide 140 mg/kg/day to HFD fed mice (Group3) for 4 weeks resulted in significant (P < 0.05) decline in the food intake and bodyweight of this group as compared with HFD control. Furthermore, niclosamide also resulted in significant (P < 0.05) lowering of the fasting blood glucose, fasting plasma insulin and improve insulin resistance. Likewise, niclosamide ameliorates the harmful effects of HFD on lipid profile by significant lowering of cholesterol, triglycerides, and LDL (P < 0.05). Niclosamide has promising effects as an anti-obesity drug. It not just lowers bodyweight in mice, but, at the same time, it reverses metabolic disturbance induced by obesity.

Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models. Participants were 185 women aged 18–25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt. Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt. Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change. Level I, evidence obtained from a properly designed randomized controlled trial.

Anorexia nervosa is an eating disorder that primarily affects young women and has a high morbidity and mortality rate. Hospitalization effectively overcomes the acute phase, prevents progression to chronicity and promotes lasting changes. Our aim is to establish a prior therapeutic contract and systematize hospitalization in three stages comprising: clinical and nutritional approaches, individual and group psychotherapy, family therapy, occupational therapy, body therapy and pharmacotherapy. Because of the multiple determination of anorexia nervosa and the risk involved, treatment must be carried out by a multidisciplinary team.

Adults with bulimia nervosa (BN) and co-occurring emotional dysregulation and multiple impulsive behaviors are less responsive to existing interventions. Initial data suggest that the combination of Dialectical Behavior Therapy (DBT) and a mood stabilizer, lamotrigine, significantly reduces symptoms of affective and behavioral dysregulation in these patients. Identifying candidate neurobiological mechanisms of change for this novel treatment combination may help guide future randomized controlled trials and inform new and targeted treatment development. Here, we examined neurocognitive and symptom changes in a female patient with BN and severe affective and behavioral dysregulation who received DBT and lamotrigine. Go/no-go task performance data and resting-state functional MRI scans were acquired before the initiation of lamotrigine (after 6 weeks in an intensive DBT program), and again after reaching and maintaining a stable dose of lamotrigine. The patient completed a battery of symptom measures biweekly for 18 weeks over the course of treatment. After lamotrigine initiation, the patient made fewer errors on a response inhibition task and showed increased and new connectivity within frontoparietal and frontolimbic networks involved in behavioral and affective control. Accompanying this symptom improvement, the patient reported marked reductions in bulimic symptoms, behavioral dysregulation, and reactivity to negative affect, along with increases in DBT skills use. Improved response inhibition and cognitive control network connectivity should be further investigated as neurocognitive mechanisms of change with combined DBT and lamotrigine for eating disorders. Longitudinal, controlled trials integrating neuroimaging and symptom measures are needed to fully evaluate the effects of this treatment. IV: Evidence obtained from multiple time series with or without the intervention, such as case studies.

Investigate the efficacy of a dissonance-based (DB) intervention (i.e., the Body Project), during which some examples of intuitive eating were provided by peer leaders, in improving intuitive eating and targeting risk and protective factors for eating disorders (ED) among Brazilian women with body dissatisfaction. Participants were randomized to a four-session DB intervention (n = 38) or assessment-only control (AOC) (n = 36), and completed validated measures assessing intuitive eating, body appreciation, self-esteem, body-ideal internalization, body dissatisfaction, negative affect, and disordered eating pre-intervention, post-intervention, and at 4- and 24-week follow-ups. The DB condition demonstrated significantly greater increases in intuitive eating, body appreciation and self-esteem scores compared to AOC from pre-intervention to post-intervention (between-condition Cohen's d = 0.73–0.98), 4-week (between-condition Cohen's d = 1.25–1.87) and 24-week follow-up (between-condition Cohen's d = 0.82–1.38). Also, the DB condition showed significantly greater decreases in body-ideal internalization, body dissatisfaction and disordered eating scores from pre-intervention to post-intervention (between-condition Cohen's d = 0.76–1.04), 4-week (between-condition Cohen's d = 1.27–1.71) and 24-week follow-up (between-condition Cohen's d = 1.04–1.19). Regarding negative affect, DB condition showed significantly greater reduction only at 24-week follow-up (between-condition Cohen’s d = 0.60). Results reinforce the efficacy of DB interventions in reducing ED risk factors for young women and support the preliminary efficacy of these programs in improving intuitive eating, body appreciation, and self-esteem. Level I, randomized controlled trial. ReBEC (Brazilian Registry of Clinical Trials; available at http://www.ensaiosclinicos.gov.br/ ) number of registration: RBR-2f57cs. Date of registration: June 1, 2020.

The aims of the current study were: (a) to compare community adolescent groups with and without binge eating (BE) on attachment representations and alexithymia, using an age-adapted interview to assess attachment; and (b) to explore the independent role of attachment and alexithymia as potentially related to BE in community adolescents. Three hundred eighty-two community adolescents were screened with respect to BE symptoms through the Binge Eating Scale (BES). The 22 girls identified with BE (BE group) and 22 age- and gender-matched peers without BE (NBE group) were assessed with the Friends and Family Interview (FFI) and the Toronto Alexithymia Scale (TAS-20). Binge eating group reported greater attachment preoccupation in comparison to NBE, while no difference emerged in alexithymia. More insecure attachment patterns, both preoccupied and dismissing, were significantly and independently associated with BES score in community girls. Insecure attachment, assessed with semi-structured interview, is associated with BE among adolescents’ community girls, while apparently alexithymia is not. Future prospective studies should assess the role of attachment in the development of BE in adolescents. III, case–control analytic study.