Obesity and the Mind: A Chicken and Egg Problem?

8/20/2019 Obesity and the Mind: A Chicken and Egg Problem?

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©2016 MFMER | slide-1

Obesity and the Mind:

A Chicken-and-Egg P!ble"

#aen $% &!the' Ph(' A$PP' )P

*ati!nal Pess F!+ndati!nFeb+ay 2,' 2016


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(iscl!s+e

Releant .inancial elati!nshi/s

*!ne

O..-label inestigati!nal +ses

*!ne


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©2016 MFMER | slide-,

Obecties

(isc+ss /sych!l!gical .act!s that in.l+ence:

Obesity

eat"ent !. !besity

$ehai!al inteenti!n


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©2016 MFMER | slide-34!+ce: he Obesity 4!ciety 5n.!ga/hic ask F!ce' *!e"be 201


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©2016 MFMER | slide-


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Obesity and (e/essi!n

!tal Men 7!"en0

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20

2

,0

,

30

3

0

3,%2

,6%8

36%9

,, ,2%6 ,,%3

Age-adjusted percentage of adults aged 20 and over who were obese, by sex and depression status: United States, 200!20"0

(e/essi!n *! (e/essi!n

#ercent

Patt )A' $!dy (% (e/essi!n and !besity in the ;%4% ad+lt h!+seh!ld /!/+lati!n' 200


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Obesity and (e/essi!n

)!ngit+dinal analysis

Obese /es!ns: > isk !. de/essi!n

(e/essed /es!ns: 8> isk !. !besity

*! di..eences bet?een "en and ?!"en

M!e /!n!+nced a"!ng A"eicans

Fl!iana 4% )+//in!' M(@ )e!n!e M% de 7it' M4@ Pa+l F% $!+y' M(' Ph(@ he! 4tinen' Ph(@ Pi" C+i/es' Ph(@ $enda 7% % =% Pennin'

Ph(@ Fans &% Bit"an' M(' Ph(% Oe?eight' Obesity' and (e/essi!n: A 4yste"atic Reie? and Meta-analysis !. )!ngit+dinal 4t+dies% Arch

Gen Psychiatry. 2010@69,D:220-22% d!i:10%1001achgen/sychiaty%2010%2@


8/36©2016 MFMER | slide-8

a+"a hist!y

Ete"e !besity ass!ciated ?ith hist!y !. a/e'

"!lestati!n' ci"e icti"iGati!n' P4(

*ati!nal sa"/le !. ,'012 ?!"en

Obesity s+gey sa"/les

20-,2> childh!!d se+al ab+se

F! s!"e /atients' ?eight is /!tectie

Felitti' 1,@ $e?et!n et al%' 201 #ing et al' 16@ $+se et al%' 2003


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E"!ti!nal eating

A..ect eg+lati!n' esca/e' /hysi!l!gical

Haies by indiid+al

E"!ti!nal eates c!ns+"e "!e s?eet'

high-.at .!!ds

Men: "eal-ty/e c!".!t .!!ds

7!"en: s?eet snacks' cab!hydates

Haies by e"!ti!n

Can i"/act entie /!cess !. ingesti!n

Eni!n"ental in.l+ence

#!nttinen et al%' 2010@ 7ansink et al%' 200,' 2013@ Ees et al%' 201,


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Macht 2008

Eating changes in es/!nse t! stess

#+"che I Meye 16,D P+del 183D P!//e et al% 18D7einstein et al% 19D0>

10>

20>

,0>

30>

0>

60>

90>

80>

eat "!e

eat less


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*ight Eating 4ynd!"e

M!ning an!eia

Eening hy/e/hagia

2-0> cal!ic intake a.te eening "eal

A?akening !ncenight , nights?eek

C!ns+"/ti!n !. high cal!ie snacks d+ing

a?akenings M!e c!""!n d+ing stess.+l /ei!ds

;/ t! 30> !. /atients

Allis!n I 4t+nkad' 2003


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$inge Eating (is!de

)age a"!+nt' sh!t ti"e' l!ss !. c!nt!l

Ra/id' secetie' +ntil +nc!".!tably .+ll

Pealence: ,-> !. ?!"en' 2> !. "en

10-1> teat"ent seeking

EJ+ally distib+ted by ace

A"eican Psychiatic Ass!ciati!n' (iagn!stic and 4tatistical Man+al !. Mental (is!des (4M-D' 201,%


13/36©2016 MFMER | slide-1,

$inge Eating and (e/essi!n

Mac+s et al%' 188elch I Aga' 137adden et al%' 1,$!dy et al%' 13#+ehnel I 7adden' 13M+ssell et al%' 160

23

6

8

10

12

13

16

18

20

$inge eating

*!n binge-eating

$ec% &epression 'nventory

Wadden et al., 2002


14/36©2016 MFMER | slide-13

F!!d Addicti!n

4i"ila sy"/t!"at!l!gy t! s+bstance de/endence

$ehai!al and ne+!/hysi!l!gical eidence

$ain K eni!n"ent inteacti!n

C!nnecti!n ?ith $E(

23> !. th!se ?ith FA did n!t hae $E(

Pealence: 11> t! 9>

#!ball AM' Clak MM' C!llaG!-Claell M' #ell!gg ' A"es &' Ebbet ' &!the #$% he elati!nshi/ a"!ng .!!d addicti!n' negatie "!!d' and

eating-dis!deed behai!s in /atients seeking t! hae baiatic s+gey% 4+g Obes Relat (is% 201 A/ 22% PM5(:2618,,02%

(O5:10%1016%s!ad%201%03%00%Mac+s MM' 7ildes E% (is!deed eating in !bese indiid+als% C+ O/in Psychiaty 2013' 29:33,-339%(O5:10%109LCO%000000000000010,


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5"/act !n eat"ent


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(e/essi!n and $aiatic 4+gey

22> t! > li.eti"e hist!y !. de/essi!n

30> !. /atients !n antide/essant

(e/essi!n d!es n!t al?ays es!le

)!ng-te" /!st!/eatie +se !. /sych!t!/ics

RL&$ "ay a..ect abs!/ti!n' distib+ti!n'

eli"inati!n

Risk .! /!! ?eight !+tc!"es

5ncease isk !. sel.-ha"

$hatti et al%' 201@)egenba+e et al%' 2012@ Mitchell et al%' 201,@ R!eig et al%' 2012@ 4te..en et al%' 2012


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a+"a =ist!y

Attiti!n

5nceased distess

)!se less ?eight in $7)P EJ+ialent ?eight l!ss 2 yeas /!st s+gey

5nceased isk !. /sychiatic h!s/italiGati!ns

$+se et al%' 2003@ Clak et al%' 2009


18/36©2016 MFMER | slide-18

F!!d Addicti!n I 7eight )!ss

FA elated t! less ?eight l!ss

a.te bie. $7)P

/!st-baiatic s+gey

FA n!t elated t! ?eight l!ss !+tc!"es

! attiti!n in $7)P

2 yeas /!st RL&$

$+"eiste et al%' 2012@ Clak I 4a+les' 201,@ #!ball et al%' 201@ )ent et al%' 201,


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Alc!h!l and $aiatic 4+gey

#re-(p )ear " )ear 2

A;( 9%0> 9%> "0*+

Alc!h!l-elated ha" 6%1> 9%,> *.

Alc!h!l de/endence 2%6> ,%8> /*0

A;(5 8 2%3> ,%6> /*

#ing et al%' AMA 2012@,09:21-22

Pe!/ s% y 1 /N%2@ Pe!/ s L 2 / %001@ 1 y s 2 y /N%02

n N 1'3


20/36©2016 MFMER | slide-20

1 2 , 3 6 8100

2

3

6

8

10

12

Swedish (bese Subjects

C!nt!l $anding H$& &$P

1ollow-up tie, year

#roportion of patients reporting ediu ris% alcohol consuption 34

Alc!h!l and $aiatic 4+gey

4enss!n et al%' 201, Obesity


21/36©2016 MFMER | slide-21

4!+ce: he Obesity 4!ciety 5n.!ga/hic ask F!ce' *!e"be 201


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y/ical (ietes )!ss&ain C!+se

5eight

6ie


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Obesity eat"ent

7ifestyle 8odification

(iet Physical Actiity $ehai! change

Medicati!ns .! ?eight l!ss

End!sc!/ic /!ced+es

5nceased

isks

A"!+nt !.?eight l!ss

10>

10-1>

1-20>

$aiatic s+gey 2-3>


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Expert panel report: Guidelines (2013) or the !ana"e!ent o o#er$ei"ht and obesity in adults.

Obesity 201% 22(&2): &%1'&%10


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$ehai!al 5nteenti!n

;sed intechangeably ?ith li.estyle inteenti!n

(iet

Physical actiity

$ehai! thea/y

echniJ+es t! e/lace "alada/tie behai!s?ith ne? eating and actiity habits

4a?e' &een' Hette' 7adden% $ehai! thea/y ?hee ae ?e n!?Q

C+ O/in End!cin!l (iabetes Obes 200@16:,39-,2%


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$ehai! hea/y .! Obesity

Self-onitoring

4ti"+l+sC!nt!l

4!cial4+//!t

Mind.+lEating

C!gnitieRest+ct+ing

&!al 4etting

7adden et al% irculation 2012


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$ake' Ray"!nd C%' and (aniel 4% #ischenba+"% 4el.-M!nit!ing May $e *ecessay .! 4+ccess.+l 7eight C!nt!l%Seha#ior *herapy 23' n!% , 1,D: ,99


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4el.-"!nit!ing

C!nsistent /edict! !. ?eight l!ss

Cal!ie intake +ndeesti"ated +/ t! 0>

=igh .eJ+ency K c!nsistency N "!e ?eight l!ss

Elect!nic t!!ls "ay be bette

F!!d' ?eight' /hysical actiity

$+ke )E' 7ang ' 4eick MA% 4el.-"!nit!ing in ?eight l!ss: A syste"atic eie? !. the liteat+e% A" (iet Ass!c 2011@111:2@ Petes!n et al%' Obesity 2013@22:162-169%


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5denti.y and Manage igges

Pe!/le

Places

i"es !. day

E"!ti!ns

4!cial eents

Cetain .!!ds


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©2016 MFMER | slide-,0

Challenge L!+ igges

A!id' li"it' ! "aste tiggest! stay !n tack

;se a .!!d diay ! !the

sel.-"!nit!ing deice ;se e?ads n!t .!!dTD

Mind.+lness a//!ach


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O+tc!"es

7eight l!ss indicated and desied

)i.estyle inteenti!ns

8 kg in 6 "!nths U - 10>D

&eate than +s+al cae

Haiability

Expert panel report: Guidelines (2013) or the !ana"e!ent o o#er$ei"ht and obesity in adults. Obesity 201% 22(&2): &%1'&%10

4!+ce: ;C!nn R+dd Cente .! F!!d P!licy I Obesity


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Relati!nshi/ $et?een Physical Actiity andMaintenance !. 7eight )!ss

*!t Maintained Maintained0

20

30

60

80

100

Subjects ;xercising 34

#ay"an 4' $+!ld 7' 4ten 4% Maintenance and ela/se a.te ?eight l!ss in ?!"en: behai!al as/ects% A! + lin ,utr 10@2:800-809%7yatt =' Catenacci HA% he !le !. /hysical actiity in /!d+cing and "aintaining ?eight l!ss% ,at lin Pract Endocrinol -etab 2009@,9D:18-2%

P0%001


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©2016 MFMER | slide-,,

4+""ay

Many /sych!l!gical as/ects t! eating and ?eight

(e/essi!n can lead t! !besity and ice esa

F! s!"e /e!/le' ?eight is /!tectie

4el.-"!nit!ing dietay intake is best /edict! !.

$ei"ht loss

Physical actiity is best /edict! !. $ei"ht loss

!aintenance


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©2016 MFMER | slide-,

7eight $ias

*egatie attit+des that negatiely in.l+ence

inteacti!ns

Obseed in childen' /aents' health cae

/!ides' "edia

A..ects e"/l!y"ent' ed+cati!n' health cae

4!cial' /sych!l!gical' /hysical c!nseJ+ences

4tig"atiGing ide!s ?ith !nline ne?s st!ies

htt/:???%+c!nn+ddcente%!g"edia-galley

P+hl et al% =eadless' h+ngy' and +nhealthy: A ide! c!ntent analysis !. !bses /es!ns /!tayed in !nline ne?s% +

ealth o!! 201,@0:1-19

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Obesity and the Mind: A Chicken and Egg Problem?